MEDICARE: JEFFREY S GELLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	158759	MA

General Provider Information

NPI Number	:	1265427694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY S GELLER MD

Provider Business Mailing Address
First Line	:	360 MERRIMACK ST STE 9
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01843-1764
Country	:	US
Telephone Number	:	978-655-6652
Fax Number	:	789-655-6653

Provider Business Practice Location Address
First Line	:	360 MERRIMACK ST STE 9
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01843-1764
Country	:	US
Telephone Number	:	978-655-6652
Fax Number	:	789-655-6653

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	10/04/2019

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Directions to “ JEFFREY S GELLER MD” Practice Location

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