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Individual

DR. CHARLES PATRICK GENNAULA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 PEASANT VILLAGE LN, SUITE 100, BELLE VERNON, PA 15012-4333
(724) 929-7800
(724) 929-3229
Mailing address
315 STETTLER DR, JEFFERSON HILLS, PA 15025-3164
(412) 287-0699
(724) 929-3229

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD050096L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015218170004
PA
05
0018903290001
PA
05
0018903290004
PA
Enumeration date
07/07/2005
Last updated
05/08/2017
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