Gennaco, Vincent John

Gennaco, Vincent John is an sole proprietor health care provider with primary practice located at 6 Norman St , Salem MA 01970-3314. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Gennaco, Vincent John can be contacted via phone (978) 745-5114.

Contact Information

Primary practice address
6 Norman St Salem MA 01970-3314
Fax: (781) 631-5537
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 359 Massachusetts

Profile Details

NPI number 1134164064
LBN Legal business name Gennaco, Vincent John
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2006
Last updated Jul 7th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134164064 NPPES
Massachusetts MEDICAID 0503789

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