Provider Demographics
NPI:1235129040
Name:GEARY, MARY ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:GEARY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 INWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1808
Mailing Address - Country:US
Mailing Address - Phone:973-635-4088
Mailing Address - Fax:
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-522-7335
Practice Address - Fax:908-522-7340
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN63123363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS66494Medicare ID - Type Unspecified