Provider Demographics
NPI:1164682050
Name:GEFFNER, MICHAL
Entity Type:Individual
Prefix:MS
First Name:MICHAL
Middle Name:
Last Name:GEFFNER
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 1:777 PASSAIC AVE
Mailing Address - Street 2:SUITE 365 5TH FLOOR
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1804
Mailing Address - Country:US
Mailing Address - Phone:973-815-0777
Mailing Address - Fax:973-815-0737
Practice Address - Street 1:777 PASSAIC AVE
Practice Address - Street 2:SUITE 365 5TH FLOOR
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1804
Practice Address - Country:US
Practice Address - Phone:973-815-0777
Practice Address - Fax:973-815-0737
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL054084001041C0700X
NY0699511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical