Provider Demographics
NPI:1558003103
Name:GELLER, JOSHUA ADAM
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ADAM
Last Name:GELLER
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 1:1031 HAGAN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-3235
Mailing Address - Country:US
Mailing Address - Phone:913-231-5503
Mailing Address - Fax:
Practice Address - Street 1:2201 CHILDRENS WAY STE 1221
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3164
Practice Address - Country:US
Practice Address - Phone:615-322-0738
Practice Address - Fax:615-322-4586
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program