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General NPI Number Information
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NPI Number | 1295170660
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Entity Type | Organization
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Legal Business Name | GENESEE VALLEY GROUP HEALTH ASSOCIATION
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 800 CARTER ST
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City | ROCHESTER
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State | NY
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Zip | 14621-2604
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Country | US
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Telephone | 585-338-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 333 BUTTERNUT DR 3RD FLOOR ATTN TONI RADLEY
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City | SYRACUSE
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State | NY
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Zip | 13214-2141
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Country | US
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Telephone | 315-671-6951
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Fax | 315-671-6976
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | MRS. DEBORAH CARLASCIO
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Credential |
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Telephone | 585-389-6066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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