Individual
JUSTIN GENOVESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 LEDGE RD, LAKE HOPATCONG, NJ 07849-1746
(201) 259-1690
Mailing address
15 E 40TH ST, NEW YORK, NY 10016-0401
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38519
NJ
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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