Active NPI
Louis B Gennarelli, MD
- Urology Physician
- Bronx, NY
National Provider Identifier
1710148150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 109297
- Practice address
- 3250 Westchester Ave
Bronx, NY 10461-4500 - Phone
- (718) 823-3666
- NPI assigned
- Jun 18, 2008
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 109297 | NY | Primary |
Addresses
Primary practice location
3250 Westchester Ave
Bronx, NY 10461-4500
Mailing address
3250 Westchester Ave
Bronx, NY 10461-4500
Phone (718) 823-3666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1001938023 | Medicaid | NY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109297 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1710148150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 WESTCHESTER AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104614500",
"telephone_number": "718-823-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3250 WESTCHESTER AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104614500",
"telephone_number": "718-823-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENNARELLI",
"first_name": "LOUIS",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "109297",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1001938023",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.