STACEY GEOGHEGAN


Address: 684 Washington St Apt 3b, New York, NY 10014-2507
Phone: 6463572209

STACEY GEOGHEGAN (NPI# 1336761907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336761907
Entity Type Individual
Full Name STACEY GEOGHEGAN
Credential NP
Practice Address 684 Washington St Apt 3b
New York
NY 10014-2507
Practice Telephone 6463572209
Mailing Telephone 6463572209
Enumeration Date 2020-05-17
Last Update Date 2020-05-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
F309321-01 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 684 WASHINGTON ST APT 3B
City NEW YORK
State NY
Zip Code 10014-2507

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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Competitor

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City NEW YORK
Zip Code 10014

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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