Provider Demographics
NPI:1205932613
Name:GEIGER, DANIELLE LYNN (RD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNN
Last Name:GEIGER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 DEER PARK AVE.
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729
Mailing Address - Country:US
Mailing Address - Phone:631-940-7777
Mailing Address - Fax:631-940-7777
Practice Address - Street 1:1913 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729
Practice Address - Country:US
Practice Address - Phone:631-940-7777
Practice Address - Fax:631-940-7777
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005337133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9543E1Medicare PIN