Provider Demographics
NPI:1316582778
Name:GEROPSYCH PSYCHIATRY, LTD
Entity Type:Organization
Organization Name:GEROPSYCH PSYCHIATRY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-779-2433
Mailing Address - Street 1:151 ORCHARDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5836
Mailing Address - Country:US
Mailing Address - Phone:440-223-3893
Mailing Address - Fax:
Practice Address - Street 1:151 ORCHARDVIEW RD STE 2B
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-5836
Practice Address - Country:US
Practice Address - Phone:844-779-2433
Practice Address - Fax:844-779-2439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GEROPSYCH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-08
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty