Provider Demographics
NPI:1861640062
Name:GERACI, JOSEPH CARL III
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CARL
Last Name:GERACI
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 SWIFT ROAD
Mailing Address - Street 2:BS&L UNITED STATES MILITARY ACADEMY
Mailing Address - City:WEST POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10996
Mailing Address - Country:US
Mailing Address - Phone:845-938-4475
Mailing Address - Fax:
Practice Address - Street 1:646 SWIFT ROAD
Practice Address - Street 2:BS&L UNITED STATES MILITARY ACADEMY
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996
Practice Address - Country:US
Practice Address - Phone:845-938-4475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health