Provider Demographics
NPI:1932180114
Name:GENOVESE, FRANK NICHOLAS (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:NICHOLAS
Last Name:GENOVESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018262E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012572600002Medicaid
0148650001OtherDMER
PA441181865OtherRAILROAD MEDICARE
PA079662K07Medicare PIN
PA0012572600002Medicaid