Individual
BRUCE C. GENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
65 NEWTON ST, NORTHBOROUGH, MA 01532-1114
(508) 393-6590
Mailing address
65 NEWTON ST, NORTHBOROUGH, MA 01532-1114
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN200044
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110106155A
—
MA
Enumeration date
03/31/2006
Last updated
09/16/2021
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