Basic Information
| Provider Information | |||||||||
| NPI: | 1811917685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GENAU | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 EXETER RD | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142213312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166345204 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 COMMUNITY DR | ||||||||
| Address2: | |||||||||
| City: | CHEEKTOWAGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142252523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165055630 | ||||||||
| FaxNumber: | 7168921936 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 02/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 008272-1 | NY | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 213EP1101X | N005026 | NY | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Primary Podiatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00010252003 | 01 | NY | UNIVERA | OTHER | 000511813004 | 01 | NY | BLUE CROSS/BLUE SHIELD | OTHER | 1093490001 | 01 | NY | MEDICARE DME | OTHER | 480020050 | 01 | NY | MEDICARE RAILROAD | OTHER |