Basic Information
| Provider Information | |||||||||
| NPI: | 1457844920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERAGHTY | ||||||||
| FirstName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 955 YONKERS AVE | ||||||||
| Address2: | STE 109 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107043063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147767310 | ||||||||
| FaxNumber: | 9147767566 | ||||||||
| Practice Location | |||||||||
| Address1: | 1053 W BOSTON POST RD | ||||||||
| Address2: | |||||||||
| City: | MAMARONECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105433329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143810203 | ||||||||
| FaxNumber: | 9143810207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2018 | ||||||||
| LastUpdateDate: | 11/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 042759 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.