Provider Demographics
NPI:1053988303
Name:VERNO, GEOFREY
Entity type:Individual
Prefix:
First Name:GEOFREY
Middle Name:
Last Name:VERNO
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 1:90 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2308
Mailing Address - Country:US
Mailing Address - Phone:631-565-3382
Mailing Address - Fax:
Practice Address - Street 1:90 HARDING ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2308
Practice Address - Country:US
Practice Address - Phone:631-565-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340837-01164W00000X
NY891591163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No164W00000XNursing Service ProvidersLicensed Practical Nurse