Organization
GENESIS MEDICAL CENTER OF KENOSHA, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN GARRETTO (OFFICE MANAGER)
(262) 652-3500
Entity
Organization
Contact information
Practice address
1020 35TH ST, KENOSHA, WI 53140-1902
(262) 652-3500
(262) 925-8353
Mailing address
1020 35TH ST, KENOSHA, WI 53140-1902
(262) 652-3500
(262) 925-8353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21301500
—
WI
Enumeration date
06/16/2006
Last updated
04/20/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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