Individual
JAY DAVID GELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 ROUTE 24, SUITE B1A, CHESTER, NJ 07930-2625
(908) 879-8800
(908) 879-2955
Mailing address
PO BOX 399, CHESTER, NJ 07930-0399
(908) 879-8800
(908) 879-2955
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA05059400
NJ
207ND0900X
Dermatopathology Physician
25MA05059400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223167652
TAXPAYER I.D.
NJ
05
—
5083401
—
NJ
Enumeration date
08/03/2005
Last updated
11/20/2012
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