Provider Demographics
NPI:1891253902
Name:GELLER, JONATHAN H (RPH)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:GELLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8665 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3020
Mailing Address - Country:US
Mailing Address - Phone:410-574-4766
Mailing Address - Fax:844-411-6243
Practice Address - Street 1:8665 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3020
Practice Address - Country:US
Practice Address - Phone:410-574-4766
Practice Address - Fax:844-411-6243
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist