Provider Demographics
NPI:1801002746
Name:GEIDEL, EVE L (ANP)
Entity Type:Individual
Prefix:MRS
First Name:EVE
Middle Name:L
Last Name:GEIDEL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 MAIN STREET
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214
Mailing Address - Country:US
Mailing Address - Phone:716-862-1412
Mailing Address - Fax:716-862-0252
Practice Address - Street 1:2157 MAIN STREET
Practice Address - Street 2:DEPARTMENT OF SURGERY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-862-1412
Practice Address - Fax:716-862-0252
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300535-1363LA2200X
NY300535363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health