Provider Demographics
NPI:1396259941
Name:CIJO, GEOCIA ANN (FNP)
Entity type:Individual
Prefix:
First Name:GEOCIA
Middle Name:ANN
Last Name:CIJO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GEOCIA
Other - Middle Name:ANN
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 EILEEN WAY UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5313
Mailing Address - Country:US
Mailing Address - Phone:516-855-5255
Mailing Address - Fax:
Practice Address - Street 1:150 EILEEN WAY UNIT 1
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5313
Practice Address - Country:US
Practice Address - Phone:516-855-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341084-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily