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General NPI Number Information
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NPI Number | 1093935967
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Entity Type | Organization
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Legal Business Name | INDEPENDENT LIVING FOR SENIORS - FEE FOR SERVICE
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2066 HUDSON AVE
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City | ROCHESTER
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State | NY
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Zip | 14617-4300
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Country | US
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Telephone | 585-922-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2066 HUDSON AVE
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City | ROCHESTER
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State | NY
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Zip | 14617-4300
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Country | US
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Telephone | 585-922-2800
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Fax |
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Authorized Official
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Title or Position | VP-PATIENT FINANCIAL SERVICES
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Name | MR. JOHN P MIDOLO
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Credential |
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Telephone | 585-922-1958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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