Provider Demographics
NPI:1790509990
Name:GERAUGHTY, AISHA ZAKIA
Entity type:Individual
Prefix:MS
First Name:AISHA
Middle Name:ZAKIA
Last Name:GERAUGHTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AISHA
Other - Middle Name:ZAKIA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 PHILPOTT LN
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:WV
Mailing Address - Zip Code:25813-9501
Mailing Address - Country:US
Mailing Address - Phone:304-223-3733
Mailing Address - Fax:304-254-9263
Practice Address - Street 1:175 PHILPOTT LN
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:WV
Practice Address - Zip Code:25813-9501
Practice Address - Country:US
Practice Address - Phone:304-223-3733
Practice Address - Fax:304-254-9263
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory