Healthcare Provider Details

I. General information

NPI: 1659871457
Provider Name (Legal Business Name): HIGHLAND HOSPITAL OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 684
ROCHESTER NY
14642-0002
US

V. Phone/Fax

Practice location:
  • Phone: 585-473-2200
  • Fax:
Mailing address:
  • Phone: 585-784-9503
  • Fax: 585-784-8207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUCINDA BECKER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 585-341-6711