MEDICARE: CARINA GENAO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1093486300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARINA GENAO

Provider Business Mailing Address
First Line	:	5011 8TH AVE APT 2F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 MARLBOROUGH RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-2606
Country	:	US
Telephone Number	:	646-509-5140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2021
Last Update Date	:	09/26/2021

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Directions to “ CARINA GENAO ” Practice Location

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