Provider Demographics
NPI:1134665524
Name:GEAGAN, JAMIE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GEAGAN
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:PO BOX 6000
Mailing Address - Street 2:INSTITUTE FOR CHILD DEVELOPMENT
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13902-6000
Mailing Address - Country:US
Mailing Address - Phone:607-777-2829
Mailing Address - Fax:607-777-6981
Practice Address - Street 1:4400 VESTAL PARKWAY EAST
Practice Address - Street 2:BINGHAMTON UNIVERSITY INSTITUTE FOR CHILD DEVELOPMENT
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13902-6000
Practice Address - Country:US
Practice Address - Phone:607-777-2829
Practice Address - Fax:607-777-6981
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist