Healthcare Provider Details
I. General information
NPI: 1376820241
Provider Name (Legal Business Name): HIGHLAND HOSPITAL OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2011
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 SOUTH AVE
ROCHESTER NY
14620-2733
US
IV. Provider business mailing address
1000 SOUTH AVE BOX 58
ROCHESTER NY
14620-2733
US
V. Phone/Fax
- Phone: 585-473-2200
- Fax:
- Phone: 585-341-0209
- Fax: 585-341-8096
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUCINDA
BECKER
Title or Position: CHIEF OPERATION OFFICER
Credential:
Phone: 585-341-6711