Individual
EVAN GELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 N COUNTRY RD, SUITE 203, PORT JEFFERSON, NY 11777-2161
(631) 474-0707
(631) 474-4034
Mailing address
333 ROUTE 25A, SUITE 225, ROCKY POINT, NY 11778-8556
(631) 474-0707
(631) 474-4034
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
170433
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01033958
—
NY
Enumeration date
07/19/2006
Last updated
07/20/2015
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