Provider Demographics
NPI:1699511808
Name:GEITER, ANTONIA SHANTIAY
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:SHANTIAY
Last Name:GEITER
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 1:31701 N MARGINAL DR APT D
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4425
Mailing Address - Country:US
Mailing Address - Phone:440-283-7959
Mailing Address - Fax:
Practice Address - Street 1:31701 N MARGINAL DR APT D
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-4425
Practice Address - Country:US
Practice Address - Phone:440-283-7959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide