Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 25MD00155500 | NJ |
N | 222Z00000X | Podiatrist | 25MD00155500 | NJ |
N | 213EP0504X | Public Medicine | 25MD00155500 | NJ |
N | 213EP1101X | Primary Podiatric Medicine | 25MD00155500 | NJ |
N | 111NR0200X | Radiology | 25MD00155500 | NJ |
N | 213ER0200X | Radiology | 25MD00155500 | NJ |
N | 2081S0010X | Sports Medicine | 25MD00155500 | NJ |
N | 213ES0000X | Sports Medicine | 25MD00155500 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | 25MD00155500 | NJ |
N | 213ES0131X | Foot Surgery | 25MD00155500 | NJ |
NPI | 1982797940 |
---|---|
Provider Name | James Genakos |
First Address | Dover, NJ 07801-1804 |
Second Address | Dover, NJ 07801-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0047076 | GHI (01) | |
0477168 | US HEALTHCARE (01) | |
J015998 | CHAMPUS (01) | |
P41871 | EMPIRE BS (01) | |
T73096 | (02) | NJ |