Individual
DR. MARIO NICHOLAS GENOVESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
9602 4TH AVE, APT. L1, BROOKLYN, NY 11209
(718) 748-7474
(718) 748-7600
Mailing address
9602 4TH AVE, APT. L1, BROOKLYN, NY 11209-3439
(718) 748-7474
(718) 667-0782
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N004091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01008846
—
NY
01
—
11-3504574
TAX IDENTIFICATION NUMBER
NY
Enumeration date
11/01/2006
Last updated
05/12/2025
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