Provider Demographics
NPI:1497706089
Name:GERIA, MICHAEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:GERIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:525 STATE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-2164
Mailing Address - Country:US
Mailing Address - Phone:856-363-1210
Mailing Address - Fax:856-363-1211
Practice Address - Street 1:525 STATE ST STE 5
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-2164
Practice Address - Country:US
Practice Address - Phone:856-363-1210
Practice Address - Fax:856-363-1211
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05784000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G05886Medicare UPIN