Healthcare Provider Details

I. General information

NPI: 1225959554
Provider Name (Legal Business Name): MADISON MUIR GENEST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INDEPENDENCE DR
HYANNIS MA
02601-1898
US

IV. Provider business mailing address

485 SANDWICH RD APT 1
EAST FALMOUTH MA
02536-4791
US

V. Phone/Fax

Practice location:
  • Phone: 508-778-1839
  • Fax: 508-775-1245
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: