Provider Demographics
NPI:1265873616
Name:GELLER, LIANA ALEXIS (SC)
Entity type:Individual
Prefix:MS
First Name:LIANA
Middle Name:ALEXIS
Last Name:GELLER
Suffix:
Gender:F
Credentials:SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 DAHILL RD
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3573
Mailing Address - Country:US
Mailing Address - Phone:718-375-2505
Mailing Address - Fax:718-375-2472
Practice Address - Street 1:2520 BATCHELDER ST
Practice Address - Street 2:APT. 2A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1553
Practice Address - Country:US
Practice Address - Phone:718-915-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator