Healthcare Provider Details

I. General information

NPI: 1972851483
Provider Name (Legal Business Name): ROCHESTER GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 ALEXANDER ST SUITE # 200
ROCHESTER NY
14607-4000
US

IV. Provider business mailing address

224 ALEXANDER ST SUITE # 200
ROCHESTER NY
14607-4000
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-8400
  • Fax: 585-922-8405
Mailing address:
  • Phone: 585-922-8400
  • Fax: 585-922-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAULA TINCH
Title or Position: SVP-FINANCE
Credential:
Phone: 585-922-1223