Provider Demographics
NPI:1518032119
Name:BEFUMO, GENINE MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:GENINE
Middle Name:MARIE
Last Name:BEFUMO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 UNION VALLEY RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-6000
Mailing Address - Country:US
Mailing Address - Phone:609-860-5655
Mailing Address - Fax:732-432-7280
Practice Address - Street 1:111 UNION VALLEY RD STE 204
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-6000
Practice Address - Country:US
Practice Address - Phone:609-860-5655
Practice Address - Fax:609-860-6656
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00269300213ES0131X
NJMD00269300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8887101Medicaid
NJ058591Medicare ID - Type Unspecified
NJU90530Medicare UPIN