Provider Demographics
NPI:1639265150
Name:GEIGER, KEVIN D (OD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:GEIGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KATHY COURT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 SMITH ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4414
Practice Address - Country:US
Practice Address - Phone:732-442-2027
Practice Address - Fax:732-442-7076
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5196152W00000X
NY5138152W00000X
FL2652152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU38954Medicare UPIN
NJ479053WMCMedicare PIN
NJ6060310001Medicare NSC