Provider Demographics
NPI:1972921948
Name:GEORGY, JOHN (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GEORGY
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 BAIST DR
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2234
Mailing Address - Country:US
Mailing Address - Phone:908-705-4467
Mailing Address - Fax:
Practice Address - Street 1:1116 GIORDANO AVE
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-4102
Practice Address - Country:US
Practice Address - Phone:908-705-4467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296239-12081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine