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General NPI Number Information
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NPI Number | 1497075824
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Entity Type | Organization
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Legal Business Name | GENESEE VALLEY ORTHOPAEDIC ASSOCIATES PC
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 144 COURT ST
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City | GENESEO
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State | NY
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Zip | 14454-1036
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Country | US
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Telephone | 585-271-2049
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Fax | 585-473-5864
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Provider Business Mailing Address
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Address Line | 880 WESTFALL RD STE A
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City | ROCHESTER
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State | NY
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Zip | 14618-2611
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Country | US
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Telephone | 585-271-2049
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Fax | 585-473-5864
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | PAT MORAN
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Credential |
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Telephone | 585-271-2049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 130674
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License Number State | NY
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