Genesis Rehabilitation Service

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3314 Issued in MA

Legal business name

GENESIS REHABILITATION SERVICE

Practice address

200 Governors Ave
Medford, MA 02155-1644

Phone

(781) 391-5400

NPI assigned

Jun 2, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Doherty

Title

Otr/L Program Manager

Phone

(781) 391-5400

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306972800000",
    "number": "1578857942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PENDANT CT",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018106304",
            "telephone_number": "978-807-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551644",
            "telephone_number": "781-391-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS REHABILITATION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OTR/L PROGRAM MANAGER",
        "authorized_official_telephone_number": "781-391-5400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "3314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Magpantay Gaviola, FNP-BC, MSN-ED
• Amanda K Geary, M.D.
• Elana Gelbart
• Peter B. Geller
• Kimberly Gendron, LMHC
• John L. Gentuso, D.M.D.
• Daphnee Carla Georges, BS
• Gerald B. Leiber, D.M.D., P.C.
• Gerald J. Riffelmacher, M.D., PC
• Giovanni Germain

• Skilled Nursing Facility in Medford, MA
• Providers in Medford, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.