Healthcare Provider Details

I. General information

NPI: 1184668311
Provider Name (Legal Business Name): STRONG OBSTETRICS-GYNECOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-256-3887
  • Fax: 585-256-3508
Mailing address:
  • Phone: 585-273-3232
  • Fax: 585-256-3508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JILL M HETTERICH
Title or Position: SENIOR DIRECTOR FINANCE URMFG
Credential:
Phone: 585-756-4003