# MARK GENNARO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831314343
- **Authorized official:** MS. VICTORIA BETZ RVT (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (631) 385-7258

## Contact information

- **Practice address:** 270 PULASKI RD STE B, GREENLAWN, NY 11740-1605
- **Practice address phone:** (631) 385-7258
- **Practice address fax:** (877) 787-4680
- **Mailing address:** 270 PULASKI RD STE B, GREENLAWN, NY 11740-1605
- **Mailing address phone:** (631) 385-7258
- **Mailing address fax:** (877) 787-4680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 12/12/2019