IndividualActive
Geoffry De Gennaro, M.D.
NPI 1336554740 · Diagnostic Radiology Physician · Boise, ID
Provider details
- NPI number
- 1336554740
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 4301105483 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2094
Approximate (ZIP-level) locationGet directions
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Registry dates
- Enumerated
- 2014-06-24
- Last updated
- 2020-07-23
- Certified
- 2020-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.