Basic Information
| Provider Information | |||||||||
| NPI: | 1871511238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERACI | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 E 25TH ST | ||||||||
| Address2: | APT 1A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100103003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6463734411 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 611 NORTHERN BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | GREAT NECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110215207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163257000 | ||||||||
| FaxNumber: | 5163257003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 01086705A | IN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 203356 | NY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0008X | 203356 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neuromuscular Medicine |
No ID Information.