Healthcare Provider Details

I. General information

NPI: 1902221518
Provider Name (Legal Business Name): HIGHLAND HOSPITAL OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2014
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE # 58
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

1000 SOUTH AVE # 58
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6779
  • Fax: 585-341-8096
Mailing address:
  • Phone: 585-341-6779
  • Fax: 585-341-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

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