Provider Demographics
NPI:1306202593
Name:GEISSINGER, JARED
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:
Last Name:GEISSINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 HAMPDEN PLACE
Mailing Address - Street 2:
Mailing Address - City:STRAUSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17579-1123
Mailing Address - Country:US
Mailing Address - Phone:717-687-3604
Mailing Address - Fax:717-687-3604
Practice Address - Street 1:1135 HAMPDEN PLACE
Practice Address - Street 2:
Practice Address - City:STRAUSBURG
Practice Address - State:PA
Practice Address - Zip Code:17579-1123
Practice Address - Country:US
Practice Address - Phone:717-687-3604
Practice Address - Fax:717-687-3604
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058102363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical