Provider Demographics
NPI:1265448096
Name:GENIS WOMENS CARE P.C.
Entity Type:Organization
Organization Name:GENIS WOMENS CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:FEDEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-923-4500
Mailing Address - Street 1:2790 GODWIN BLVD
Mailing Address - Street 2:SUITE 375
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8151
Mailing Address - Country:US
Mailing Address - Phone:757-923-4500
Mailing Address - Fax:757-923-4607
Practice Address - Street 1:2790 GODWIN BLVD
Practice Address - Street 2:SUITE 375
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8151
Practice Address - Country:US
Practice Address - Phone:757-923-4500
Practice Address - Fax:757-923-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH22240Medicare UPIN
CAH69431Medicare UPIN
VAC08259Medicare ID - Type Unspecified