Provider Demographics
NPI:1548443906
Name:GERONIAN, ALEXANDRE (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRE
Middle Name:
Last Name:GERONIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SUMMIT TRACE RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1066
Mailing Address - Country:US
Mailing Address - Phone:724-624-3048
Mailing Address - Fax:
Practice Address - Street 1:918 KENNEBEC ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2605
Practice Address - Country:US
Practice Address - Phone:412-831-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4555792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA519977Medicare PIN