Polverino, Gennaro Marc

Polverino, Gennaro Marc is an individual health care provider with primary practice located at 1208 Driving Park Ave , Newark NY 14513-1057. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Polverino, Gennaro Marc can be contacted via phone (315) 359-2640.

Contact Information

Primary practice address
1208 Driving Park Ave Newark NY 14513-1057
Phone: (315) 359-2640
Fax: (315) 359-2645
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 272834 New York
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 272834 New York

Profile Details

NPI number 1427145184
LBN Legal business name Polverino, Gennaro Marc
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated Jan 5th, 2023 - about last year

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 1427145184 NPPES
New York MEDICAID 03941513

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