Provider Demographics
NPI:1699961136
Name:LELE, GEETA EKNATH (MD)
Entity type:Individual
Prefix:MRS
First Name:GEETA
Middle Name:EKNATH
Last Name:LELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 N TURNER ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-5148
Mailing Address - Country:US
Mailing Address - Phone:505-393-8562
Mailing Address - Fax:505-393-8562
Practice Address - Street 1:921 N TURNER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5148
Practice Address - Country:US
Practice Address - Phone:505-393-8562
Practice Address - Fax:505-393-8562
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83-72208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMC97925Medicare UPIN