Provider Demographics
NPI:1528771474
Name:GERACI, MARY F
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:GERACI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 SELKIRK BUSH RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-8714
Mailing Address - Country:US
Mailing Address - Phone:440-904-0063
Mailing Address - Fax:
Practice Address - Street 1:4155 SELKIRK BUSH RD
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-8714
Practice Address - Country:US
Practice Address - Phone:440-904-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker