Healthcare Provider Details

I. General information

NPI: 1730100538
Provider Name (Legal Business Name): BEVERLEY J GENETTI RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 POND ROAD SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
ALLENTOWN PA
18104-2258
US

IV. Provider business mailing address

1611 POND ROAD SUITE 101 LEHIGH VALLEY WOMENS CANCER CENTER
ALLENTOWN PA
18104-2258
US

V. Phone/Fax

Practice location:
  • Phone: 610-366-8555
  • Fax: 610-366-8550
Mailing address:
  • Phone: 610-366-8555
  • Fax: 610-366-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN-296009L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: