Provider Demographics
NPI:1962632570
Name:GELLER, ANDREW ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ADAM
Last Name:GELLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BRONX RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-7013
Mailing Address - Country:US
Mailing Address - Phone:914-776-1122
Mailing Address - Fax:
Practice Address - Street 1:850 BRONX RIVER RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-7013
Practice Address - Country:US
Practice Address - Phone:914-776-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP698471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice