Provider Demographics
NPI:1295837078
Name:GHANEKAR, GEETA R (MD)
Entity type:Individual
Prefix:MRS
First Name:GEETA
Middle Name:R
Last Name:GHANEKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MANDIKINI
Other - Middle Name:M
Other - Last Name:JESHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830
Mailing Address - Country:US
Mailing Address - Phone:732-283-3850
Mailing Address - Fax:732-283-3854
Practice Address - Street 1:515 ROUTE 27
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830
Practice Address - Country:US
Practice Address - Phone:732-283-3850
Practice Address - Fax:732-283-3854
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03516000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GHI130022Medicare ID - Type Unspecified
C53432Medicare UPIN