Provider Demographics
NPI:1053579425
Name:GELLER, ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:ELENA
Middle Name:
Last Name:GELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 AVENUE J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3605
Mailing Address - Country:US
Mailing Address - Phone:718-645-0600
Mailing Address - Fax:718-692-4456
Practice Address - Street 1:1301 AVENUE J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3605
Practice Address - Country:US
Practice Address - Phone:718-645-0600
Practice Address - Fax:718-692-4456
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238715207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology