Provider Demographics
NPI:1124129390
Name:GEFTER, JANNA (DPM)
Entity type:Individual
Prefix:DR
First Name:JANNA
Middle Name:
Last Name:GEFTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 WATERS EDGE DR
Mailing Address - Street 2:4D
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2232
Mailing Address - Country:US
Mailing Address - Phone:718-645-2700
Mailing Address - Fax:718-645-3188
Practice Address - Street 1:2383 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2053
Practice Address - Country:US
Practice Address - Phone:718-423-3535
Practice Address - Fax:718-423-3581
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006007-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02532763Medicaid
NY5310920001Medicare NSC
NY02532763Medicaid
NYPJ2321Medicare ID - Type Unspecified