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General NPI Number Information
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NPI Number | 1588137327
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Entity Type | Individual
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Provider Name | GENESIS BUENO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 01/04/2019
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Provider Practice Location Address
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Address Line | 308 WILLOW AVE
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City | HOBOKEN
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State | NJ
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Zip | 07030-3808
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Country | US
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Telephone | 201-418-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 167 CLERK ST APT 1
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City | JERSEY CITY
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State | NJ
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Zip | 07305-4456
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Country | US
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Telephone | 201-401-1848
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00893800
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License Number State | NJ
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