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MARK DENNIS V GERONIMO MD NPI 1215132949


NPI Information

NPI: 1215132949
Provider Name: MARK DENNIS V GERONIMO, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: WILLIAM W BACKUS HOSPITAL

PECOS Registration: Yes

Address:
365 MONTAUK AVE
NEW LONDON, CT
ZIP 06320
Phone: (860) 442-0711
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Mark Dennis V Geronimo, MD is a family medicine in New London, CT with 23 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Mark Dennis V Geronimo, MD NPI is 1215132949. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

365 MONTAUK AVE
NEW LONDON, CT
ZIP 06320-700
Phone: (860) 442-0711
Fax: (413) 543-7962

The NPI 1215132949 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2007 and was last updated on 7/22/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036128606ILLINOISNo
2207Q00000XFamily Medicine52895CONNECTICUTYes
3207Q00000XFamily Medicine2010024512MISSOURINo
4208M00000XHospitalist52895CONNECTICUTNo
5208M00000XHospitalist036128606ILLINOISNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.