Provider Demographics
NPI:1336357714
Name:NEIL GELERTER DMD PA
Entity Type:Organization
Organization Name:NEIL GELERTER DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:GELERTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-340-1988
Mailing Address - Street 1:234 CLIFTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1916
Mailing Address - Country:US
Mailing Address - Phone:973-340-1988
Mailing Address - Fax:
Practice Address - Street 1:234 CLIFTON AVENUE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1916
Practice Address - Country:US
Practice Address - Phone:973-340-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01624000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty