Healthcare Provider Details

I. General information

NPI: 1699684548
Provider Name (Legal Business Name): DIVERSE MOSAIC COMMUNITY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ANDREWS ST # 420
ROCHESTER NY
14604-1409
US

IV. Provider business mailing address

3896 DEWEY AVE # 177
ROCHESTER NY
14616-2527
US

V. Phone/Fax

Practice location:
  • Phone: 585-558-1900
  • Fax:
Mailing address:
  • Phone: 585-558-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: CHERRIESE BUFIS-SCOTT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 585-283-1997