Healthcare Provider Details

I. General information

NPI: 1699019018
Provider Name (Legal Business Name): HIGHLAND HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
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
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-7066
  • Fax:
Mailing address:
  • Phone: 585-341-7066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number307196-1
License Number StateNY

VIII. Authorized Official

Name: SALLY CAPRARELLI NORDQUIST
Title or Position: DIABETES EDUCATOR
Credential: RN
Phone: 585-341-7065