Individual
MS. NICOLE GENOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1604 EARL RD, WANTAGH, NY 11793-3118
(516) 557-9741
Mailing address
1604 EARL RD, WANTAGH, NY 11793-3118
(516) 557-9741
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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