Provider Demographics
NPI:1649433798
Name:GIEGER, KERRI (PA)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:GIEGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 OLD SHORT HILLS RD
Mailing Address - Street 2:ST BARNABAS MEDICAL CENETER
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1008
Mailing Address - Country:US
Mailing Address - Phone:973-322-5111
Mailing Address - Fax:
Practice Address - Street 1:95 OLD SHORT HILLS RD
Practice Address - Street 2:ST BARNABAS MEDICAL CENETER
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1008
Practice Address - Country:US
Practice Address - Phone:973-322-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00199200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ171411UA1Medicare PIN