Provider Demographics
NPI:1972729028
Name:GEEZA, EUGENE JOHN (PT)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:JOHN
Last Name:GEEZA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LAKE STREET
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414
Mailing Address - Country:US
Mailing Address - Phone:570-563-2606
Mailing Address - Fax:
Practice Address - Street 1:TYLER MEMORIAL HOSPITAL
Practice Address - Street 2:880 SR 6 W
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657
Practice Address - Country:US
Practice Address - Phone:570-836-7753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000352........E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist