Individual
JUSTIN GENZIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, PH5-133, NEW YORK, NY 10032-3720
(212) 305-3226
(212) 305-3204
Mailing address
231 COLCHESTER AVE, BURLINGTON, VT 05401-1411
(206) 818-8140
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A179090
CA
207LP3000X
Pediatric Anesthesiology Physician
Primary
A179090
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
05/31/2023
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