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NPI Code Detail

MEDICARE: AIDEN GENOVESE

MEDICARE: AIDEN GENOVESE
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
1235Z00000XSpeech-Language Pathologist8452LA

General Provider Information

NPI Number : 1184369209
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIDEN GENOVESE
Provider Business Mailing Address
First Line : 42283 JOSHUA DR
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-8716
Country : US
Telephone Number : 985-640-2548
Fax Number :
Provider Business Practice Location Address
First Line : 321 N THEARD ST
Second Line :
City : COVINGTON
State : LA
Zip : 70433-2835
Country : US
Telephone Number : 985-892-2276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2022
Last Update Date : 05/03/2022

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Directions to “ AIDEN GENOVESE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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