Healthcare Provider Details

I. General information

NPI: 1861836652
Provider Name (Legal Business Name): HIGHLANDS WOMENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 SOUTH AVE SUITE 103
ROCHESTER NY
14620-2763
US

IV. Provider business mailing address

990 SOUTH AVE SUITE 103
ROCHESTER NY
14620-2763
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-0101
  • Fax: 585-341-0161
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LUCINDA BECKER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 585-341-6711