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Individual

DR. GENARO J TAVERAS I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
048917

Contact information

Practice address
2002 GRAND AVE, BRONX, NY 10453-4662
(718) 299-1340
(718) 299-2760
Mailing address
2002 GRAND AV., BRONX, NY 10453-4662
(718) 299-1340
(718) 299-2760

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
048917
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02152812
NY
Enumeration date
09/26/2007
Last updated
09/26/2007
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