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Gena Marie Mastrogianakis

Family Medicine

Allopathic & Osteopathic Physicians

3595 Canton Rd Ste 116-289, Marietta, GA 30066-2658

PECOS Enrollment

This provider is enrolled in PECOS as GENA MASTROGIANAKIS.

Based on the most recent information from CMS, provider Gena Marie Mastrogianakis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1457626855
Provider Type
Individual
Full Name
Mastrogianakis, Gena Marie
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/19/2012
Last Updated
2/25/2022

Contact Information

Practice Location

3595 Canton Rd Ste 116-289, Marietta, GA 30066-2658

(404) 558-4124

Unlisted Fax

Mailing Location

3595 Canton Rd Ste 116-289, Marietta, GA 30066-2658

(404) 807-0300

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 74488 Georgia

Gena Marie Mastrogianakis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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