Provider Demographics
NPI:1588747901
Name:ANTHONY P. GERACI, MD, PC
Entity type:Organization
Organization Name:ANTHONY P. GERACI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-227-2368
Mailing Address - Street 1:233 BROADWAY
Mailing Address - Street 2:2165
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10279-2899
Mailing Address - Country:US
Mailing Address - Phone:212-227-2368
Mailing Address - Fax:212-227-2369
Practice Address - Street 1:233 BROADWAY
Practice Address - Street 2:2165
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10279-2899
Practice Address - Country:US
Practice Address - Phone:212-227-2368
Practice Address - Fax:212-227-2369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2033562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH01358Medicare UPIN