Provider Demographics
NPI:1295019586
Name:GENOVA, ARLENE
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:
Last Name:GENOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HARNDEN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-3001
Mailing Address - Country:US
Mailing Address - Phone:781-944-3092
Mailing Address - Fax:781-944-3481
Practice Address - Street 1:45 HARNDEN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867
Practice Address - Country:US
Practice Address - Phone:781-944-3092
Practice Address - Fax:781-944-3481
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist