Provider Demographics
NPI:1437129251
Name:FRANK N GENOVESE GENOVESE OPHTHALMIC ASSOCIATES
Entity Type:Organization
Organization Name:FRANK N GENOVESE GENOVESE OPHTHALMIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:GENOVESE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-543-2146
Mailing Address - Street 1:200 MEDICAL ARTS BUILDING
Mailing Address - Street 2:SUITE 210
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7132
Mailing Address - Country:US
Mailing Address - Phone:724-543-2146
Mailing Address - Fax:724-545-9678
Practice Address - Street 1:200 MEDICAL ARTS BUILDING
Practice Address - Street 2:SUITE 210
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7132
Practice Address - Country:US
Practice Address - Phone:724-543-2146
Practice Address - Fax:724-545-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 018262E332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0148650001Medicare NSC