Healthcare Provider Details

I. General information

NPI: 1184629495
Provider Name (Legal Business Name): BRIGHTONIAN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 ELMWOOD AVE
ROCHESTER NY
14620-3321
US

IV. Provider business mailing address

740 EAST AVE
ROCHESTER NY
14607-2107
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-8700
  • Fax: 585-271-6849
Mailing address:
  • Phone: 585-244-0410
  • Fax: 585-244-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2750307
License Number StateNY

VIII. Authorized Official

Name: MR. ROBERT W HURLBUT
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 585-244-0410