Healthcare Provider Details

I. General information

NPI: 1114198819
Provider Name (Legal Business Name): FINGER LAKES COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MAIN ST.
PORT BYRON NY
13140-0359
US

IV. Provider business mailing address

14 MAIDEN LN PO BOX 423
PENN YAN NY
14527-1208
US

V. Phone/Fax

Practice location:
  • Phone: 315-776-9700
  • Fax: 315-776-9700
Mailing address:
  • Phone: 315-531-9102
  • Fax: 315-531-9103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARY ZELAZNY
Title or Position: CEO
Credential:
Phone: 315-531-9102