Individual
ILYA D GENIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2073 KLOCKNER RD, HAMILTON, NJ 08690
(609) 584-1212
(609) 584-0103
Mailing address
2073 KLOCKNER RD, HAMILTON, NJ 08690
(609) 584-1212
(609) 584-0103
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA04154500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1799304
—
NJ
01
—
22-3052989
TAX ID
NJ
Enumeration date
01/05/2006
Last updated
01/28/2010
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