Individual
KARL BENJAMIN GENOVESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
73 WATERBURY RD STE 1, PROSPECT, CT 06712-1252
(203) 527-9444
Mailing address
73 WATERBURY RD STE 1, PROSPECT, CT 06712-1252
(203) 527-9444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71048
CT
207Q00000X
Family Medicine Physician
D89812
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2017
Last updated
07/05/2022
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