# MICHAEL GENCO CHIROPRACTIC PC

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

## Provider details

- **NPI number:** 1942360888
- **Authorized official:** DR. MICHAEL GENCO D. C. (PRESIDENT)
- **Authorized official phone:** (718) 268-4464

## Contact information

- **Practice address:** 11045 QUEENS BLVD, AA, FOREST HILLS, NY 11375-5501
- **Practice address phone:** (718) 268-4464
- **Practice address fax:** (718) 544-0430
- **Mailing address:** 11045 QUEENS BLVD, AA, FOREST HILLS, NY 11375-5501
- **Mailing address phone:** (718) 268-4464
- **Mailing address fax:** (718) 544-0430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 0002322 | NY | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 01/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | X2763 | BLUE CROSS | NY |