Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA07940500 | NJ |
NPI | 1083659064 |
---|---|
Provider Name | Dr. Debora K Geller |
First Address | Fairfield, NJ 07004-1583 |
Second Address | Emerson, NJ 07630-1396 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 30/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I43737 | (02) | NJ |