Healthcare Provider Details

I. General information

NPI: 1467689323
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF THE DIOCESE OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 N CLINTON AVE
ROCHESTER NY
14604-1455
US

IV. Provider business mailing address

87 N CLINTON AVE
ROCHESTER NY
14604-1455
US

V. Phone/Fax

Practice location:
  • Phone: 585-546-7220
  • Fax:
Mailing address:
  • Phone: 585-546-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN PORTANOVA
Title or Position: CEO
Credential:
Phone: 585-546-7220