Provider Demographics
NPI:1033602214
Name:GENOVA, ERIN DELL (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:DELL
Last Name:GENOVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48462 BELL SCHOOL RD STE A
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48462 BELL SCHOOL RD STE A
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9625
Practice Address - Country:US
Practice Address - Phone:724-773-3404
Practice Address - Fax:724-770-7939
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021136207Q00000X
390200000X
OH34.014470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program