Individual
GENE A GROENENDAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2861 W 26TH ST STE 2, ERIE, PA 16506-3064
(814) 480-7760
(814) 480-7761
Mailing address
2861 W 26TH ST STE 2, ERIE, PA 16506-3064
(814) 480-7760
(814) 480-7761
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS012139
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080340
MEDICARE
—
01
—
1621512
HIGHMARK
—
01
—
I08552
UPIN
—
Enumeration date
12/19/2005
Last updated
06/08/2025
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