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General NPI Number Information
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NPI Number | 1578582292
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Entity Type | Individual
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Provider Name | MARK H GENOVESI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 08/06/2021
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Provider Practice Location Address
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Address Line | 8318 4TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-4413
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Country | US
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Telephone | 718-748-0500
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Fax | 718-748-5539
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Provider Business Mailing Address
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Address Line | 1439 ROOSEVELT AVE
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City | PELHAM
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State | NY
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Zip | 10803-3607
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Country | US
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Telephone | 914-235-4004
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Fax | 718-748-5539
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 181571
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License Number State | NY
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