Provider Demographics
NPI:1205009982
Name:RECHENBERG, GEOFFREY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:MARK
Last Name:RECHENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 COMMONWEALTH AVE
Mailing Address - Street 2:APT. 519
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3616
Mailing Address - Country:US
Mailing Address - Phone:201-693-8148
Mailing Address - Fax:
Practice Address - Street 1:1455 COMMONWEALTH AVE
Practice Address - Street 2:APT. 519
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3616
Practice Address - Country:US
Practice Address - Phone:201-693-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225241207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology