Provider Demographics
NPI:1184649592
Name:GEYLER, INNA (DO)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:GEYLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2782 MILL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6422
Mailing Address - Country:US
Mailing Address - Phone:718-968-0622
Mailing Address - Fax:
Practice Address - Street 1:1220 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-376-1004
Practice Address - Fax:718-376-1150
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02079885Medicaid
NYH10364Medicare UPIN
NY14V891Medicare ID - Type Unspecified