Healthcare Provider Details

I. General information

NPI: 1285911586
Provider Name (Legal Business Name): HIGHLAND HOSPITAL OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
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 67
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6622
  • Fax: 585-341-8096
Mailing address:
  • Phone: 585-341-6622
  • Fax: 585-341-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

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