Healthcare Provider Details

I. General information

NPI: 1053417014
Provider Name (Legal Business Name): GENESEE VALLEY PODIATRY LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WHITNEY ROAD
ROCHESTER NY
14621-3064
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD STE 208
N TONAWANDA NY
14120-2019
US

V. Phone/Fax

Practice location:
  • Phone: 585-266-9140
  • Fax: 585-266-2223
Mailing address:
  • Phone: 716-692-3302
  • Fax: 716-692-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD J GENSHEIMER
Title or Position: PARTNER
Credential: DPM
Phone: 585-586-6100