Provider Demographics
NPI:1639275282
Name:GEBA, GREGORY PETER (MD, DRPH)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:PETER
Last Name:GEBA
Suffix:
Gender:M
Credentials:MD, DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HOLLOWATY KOSAK ROAD
Mailing Address - Street 2:
Mailing Address - City:GLEN SPEY
Mailing Address - State:NY
Mailing Address - Zip Code:12737
Mailing Address - Country:US
Mailing Address - Phone:908-202-5239
Mailing Address - Fax:
Practice Address - Street 1:22 HOLLOWATY KOSAK ROAD
Practice Address - Street 2:
Practice Address - City:GLEN SPEY
Practice Address - State:NY
Practice Address - Zip Code:12737
Practice Address - Country:US
Practice Address - Phone:908-202-5239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027659207RP1001X
NY173227207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology