Geller, Evan

Geller, Evan is an individual health care provider with primary practice located at 70 N Country Rd Suite 203, Port Jefferson NY 11777-2161. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Geller, Evan can be contacted via phone (631) 474-0707.

Contact Information

Primary practice address
70 N Country Rd Suite 203 Port Jefferson NY 11777-2161
Phone: (631) 474-0707
Fax: (631) 474-4034
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 170433 New York

Profile Details

NPI number 1972522811
LBN Legal business name Geller, Evan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jul 20th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972522811 NPPES
New York MEDICAID 01033958

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