Provider Demographics
NPI:1902034242
Name:GENOVESE, CYNTHIA M (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:GENOVESE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:639 STOKES RD
Mailing Address - Street 2:ST 102
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3003
Mailing Address - Country:US
Mailing Address - Phone:609-245-0416
Mailing Address - Fax:609-245-0419
Practice Address - Street 1:639 STOKES RD
Practice Address - Street 2:ST 102
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-3003
Practice Address - Country:US
Practice Address - Phone:609-245-0416
Practice Address - Fax:609-245-0419
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2016-10-29
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08575200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine