Provider Demographics
NPI:1093809949
Name:GELDWERT, JOSEF JONATHAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEF
Middle Name:JONATHAN
Last Name:GELDWERT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1111
Mailing Address - Country:US
Mailing Address - Phone:212-996-1900
Mailing Address - Fax:212-996-2110
Practice Address - Street 1:111 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1111
Practice Address - Country:US
Practice Address - Phone:212-996-1900
Practice Address - Fax:212-996-2110
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNO2528213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00418002Medicaid
NY480012311OtherRR INDIVIDUAL PROVIDER #
NYA400005693Medicare PIN
NYT50803Medicare UPIN
NYP28871Medicare PIN