Provider Demographics
NPI:1962780791
Name:GENOVESI, ANN M (RN)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:GENOVESI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 EISENHOWER CT
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-1633
Mailing Address - Country:US
Mailing Address - Phone:845-613-7510
Mailing Address - Fax:
Practice Address - Street 1:14 EISENHOWER CT
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-1633
Practice Address - Country:US
Practice Address - Phone:845-613-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY459707-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse