Provider Demographics
NPI:1629197819
Name:JAY D GELLER MD PC
Entity Type:Organization
Organization Name:JAY D GELLER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-879-8800
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-0399
Mailing Address - Country:US
Mailing Address - Phone:908-879-8800
Mailing Address - Fax:908-879-2955
Practice Address - Street 1:310 STATE ROUTE 24
Practice Address - Street 2:SUITE B1-A
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2625
Practice Address - Country:US
Practice Address - Phone:908-879-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05059400207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty