Provider Demographics
NPI:1194852194
Name:DE GENNARO, FRANK VINCENT (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:VINCENT
Last Name:DE GENNARO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6 OAKMONT LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3989
Mailing Address - Country:US
Mailing Address - Phone:732-928-1953
Mailing Address - Fax:732-928-1953
Practice Address - Street 1:6 OAKMONT LN
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-3989
Practice Address - Country:US
Practice Address - Phone:732-928-1953
Practice Address - Fax:732-928-1953
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ22165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine