NPI Code Details Logo

NPI 1821946310

NPI 1821946310 : DR. GELLER WI, S.C. : WATERTOWN, WI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1821946310
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DR. GELLER WI, S.C. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/19/2026
-----------------------------------------------------
    Last Update Date     |    03/19/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    121 HOSPITAL DR 
-----------------------------------------------------
    City                 |    WATERTOWN
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53098-3303
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    646-303-7650
-----------------------------------------------------
    Fax                  |    646-222-6468
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2119 ORIEN RD 
-----------------------------------------------------
    City                 |    TOMS RIVER
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    08755-1366
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    646-303-7650
-----------------------------------------------------
    Fax                  |    646-222-6468
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     FELIX  GELLER 
-----------------------------------------------------
    Credential           |    MD
-----------------------------------------------------
    Telephone            |    646-303-7650
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2084P0800X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatry Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.