Individual
RICHARD E. GENOVESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
31 LAKE ST, SUITE 151, GARDNER, MA 01440-3889
(978) 632-5722
(978) 630-3240
Mailing address
31 LAKE ST STE 151, GARDNER, MA 01440-3889
(978) 632-5722
(978) 630-3240
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
1625
MA
213ES0103X
Foot & Ankle Surgery Podiatrist
1652
MA
213ES0131X
Foot Surgery Podiatrist
1625
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0341975
—
MA
Enumeration date
10/27/2005
Last updated
03/30/2021
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