# DR. MARIO NICHOLAS GENOVESE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1447337738
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N004091 | NY | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 05/12/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01008846 | — | NY |
| 01 | — | 11-3504574 | TAX IDENTIFICATION NUMBER | NY |