Provider Demographics
NPI:1366874026
Name:GEAY, FIITA
Entity type:Individual
Prefix:
First Name:FIITA
Middle Name:
Last Name:GEAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 B ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4227
Mailing Address - Country:US
Mailing Address - Phone:510-600-3919
Mailing Address - Fax:
Practice Address - Street 1:1122 B STREET
Practice Address - Street 2:SUITE 307
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541
Practice Address - Country:US
Practice Address - Phone:510-600-3919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver