MEDICARE: GENESIS PERSONAL HEALTHCARE MEDICINE

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	207Q00000X	Family Medicine Physician
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1841146875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS PERSONAL HEALTHCARE MEDICINE

Provider Business Mailing Address
First Line	:	341 E 19TH ST APT 6C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5866
Country	:	US
Telephone Number	:	718-569-8127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1927 DARLINGTON OAK DR
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77304-7800
Country	:	US
Telephone Number	:	718-569-8127
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DR. GRITZ PIERRE
Credential	:	MD
Telephone Number	:	347-967-9262

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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