Provider Demographics
NPI:1578618583
Name:GELLER, DANIEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:GELLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W 58TH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1820
Mailing Address - Country:US
Mailing Address - Phone:917-546-9070
Mailing Address - Fax:866-514-9528
Practice Address - Street 1:330 W 58TH ST STE 407
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1820
Practice Address - Country:US
Practice Address - Phone:917-546-9070
Practice Address - Fax:866-514-9528
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4706213E00000X
PASC007319213ES0103X
NYN005892-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6211060003Medicare NSC
NY6211060004Medicare NSC
NY6211060004Medicare NSC