Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 18248 | CT |
NPI | 1013913995 |
---|---|
Provider Name | Dr. Michael G. Genovesi |
First Address | New Britain, CT 06051-3916 |
Second Address | New Britain, CT 06051-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001182484 | (05) | CT |
004062394 | (05) | CT |
010018248CT01 | BCBS N BCFP PROV ID (01) | CT |
01018248 | CIGNA PROV ID (01) | CT |
059108-1631 | CONNECTICARE ID (01) | CT |
060028 | HEALTH NET PROV ID (01) | CT |
1255448155 | GHMC GRP NPI ID (01) | CT |
135689 | WELLCARE MEDICARE (01) | CT |
476841 | AETNA REF ID (01) | CT |
912409 | HEALTH NET REF ID (01) | CT |
B83677 | (02) | |
P369819 | OXFORD ID (01) | CT |