Individual
DR. NICOLAS RAPHAEL GENOVESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1015881
MA
2084P0800X
Psychiatry Physician
MD25931
ME
Other
Enumeration date
03/19/2019
Last updated
05/05/2025
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