Provider Demographics
NPI:1073773271
Name:MICHAEL J. GEREMINO, D.D.S., P.C.
Entity Type:Organization
Organization Name:MICHAEL J. GEREMINO, D.D.S., P.C.
Other - Org Name:MICHAEL J. GEREMINO, D.D.S.
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GEREMINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-769-0065
Mailing Address - Street 1:47 BROOKFIELD PL
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2107
Mailing Address - Country:US
Mailing Address - Phone:914-769-0065
Mailing Address - Fax:914-769-3214
Practice Address - Street 1:47 BROOKFIELD PL
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2107
Practice Address - Country:US
Practice Address - Phone:914-769-0065
Practice Address - Fax:914-769-3214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0434211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty