Provider Demographics
NPI:1013978071
Name:THERESA GEISLER
Entity Type:Organization
Organization Name:THERESA GEISLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:GEISLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-828-3255
Mailing Address - Street 1:739 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-1301
Mailing Address - Country:US
Mailing Address - Phone:412-828-3255
Mailing Address - Fax:412-828-3655
Practice Address - Street 1:739 ALLEGHENY RIVER BLVD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-1301
Practice Address - Country:US
Practice Address - Phone:412-828-3255
Practice Address - Fax:412-828-3655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006113332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PIN90ZAOtherUPMC
PA250019360250001Medicaid
318869OtherUPMC
318869OtherUPMC