Provider Demographics
NPI:1699816249
Name:GREEN-GEIGER, CELINE MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:CELINE
Middle Name:MARIE
Last Name:GREEN-GEIGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11709-2917
Mailing Address - Country:US
Mailing Address - Phone:516-503-3933
Mailing Address - Fax:
Practice Address - Street 1:10 OAK ST
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-2917
Practice Address - Country:US
Practice Address - Phone:516-503-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020964-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist