Active NPI
Michael Genco, D. C.
- Chiropractor
- Forest Hills, NY
National Provider Identifier
1104919034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC2322
- Practice address
- 11045 Queens Blvd
Suite Aa
Forest Hills, NY 11375-5501 - Phone
- (718) 268-4464
- Fax
- (718) 544-0430
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC2322 | NY | Primary |
Addresses
Primary practice location
11045 Queens Blvd
Suite Aa
Forest Hills, NY 11375-5501
Mailing address
110 45 Queens Blvd
Suite Aa
Forest Hills, NY 11375-7432
Phone (718) 268-4464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC2322 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1104919034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 45 QUEENS BLVD",
"address_2": "SUITE AA",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757432",
"telephone_number": "718-268-4464",
"fax_number": "718-544-0430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11045 QUEENS BLVD",
"address_2": "SUITE AA",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113755501",
"telephone_number": "718-268-4464",
"fax_number": "718-544-0430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENCO",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D. C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "DC2322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.