Provider Demographics
NPI:1518932979
Name:GELLER, ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:GELLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 FESTIVAL DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4325
Mailing Address - Country:US
Mailing Address - Phone:856-782-1592
Mailing Address - Fax:856-782-8146
Practice Address - Street 1:23 FESTIVAL DR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4325
Practice Address - Country:US
Practice Address - Phone:856-782-1592
Practice Address - Fax:856-782-8146
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002929L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006708860007Medicaid
NJP00730064OtherRR MEDICARE (CHAMBERS)
NJ0260606Medicaid
NJP00730064OtherRR MEDICARE (CHAMBERS)
NJ0260606Medicaid
PAD18430Medicare UPIN