Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 76259 | MA |
NPI | 1003807587 |
---|---|
Provider Name | Dr. Daniel Albert Geller |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3096688 | (05) | MA |
E60023 | (02) |