1326592635 NPI number — MS. SHEENA ELIZABETH GEOGHEGAN M.D

Table of content: MS. SHEENA ELIZABETH GEOGHEGAN M.D (NPI 1326592635)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326592635 NPI number — MS. SHEENA ELIZABETH GEOGHEGAN M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEOGHEGAN
Provider First Name:
SHEENA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326592635
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
128 E, APPLE ST. SUITE 1820
Provider Second Line Business Mailing Address:
WSU DEPT. OF GERIATRICS
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-208-6359
Provider Business Mailing Address Fax Number:
937-208-3096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
725 UNIVERISITY BLVD.
Provider Second Line Business Practice Location Address:
WRIGHT STATE PHYSICIANS
Provider Business Practice Location Address City Name:
FAIRBORN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-245-7200
Provider Business Practice Location Address Fax Number:
937-245-7937
Provider Enumeration Date:
08/04/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com