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Organization

CHARLES P. GENNAULA, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NIKKI COSTELLO (BILLING MANAGER)
(724) 929-7800
Entity
Organization

Contact information

Practice address
100 PEASANT VILLAGE LN STE 100, ROSTRAVER TOWNSHIP, PA 15012-4333
(724) 929-7800
(724) 929-7800
Mailing address
100 PEASANT VILLAGE LN STE 100, ROSTRAVER TOWNSHIP, PA 15012-4333
(724) 929-7800
(724) 929-7800

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
05/21/2019
Last updated
05/21/2019
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