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General NPI Number Information
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NPI Number | 1780206292
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Entity Type | Organization
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Legal Business Name | GREECE ASC, LLC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 135 CANAL LANDING BLVD
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City | ROCHESTER
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State | NY
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Zip | 14626-5104
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Country | US
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Telephone | 585-328-0153
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Fax | 585-328-0158
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Provider Business Mailing Address
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Address Line | 2300 BUFFALO RD BLDG 700
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City | ROCHESTER
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State | NY
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Zip | 14624-1367
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Country | US
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Telephone | 585-328-0153
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Fax | 585-328-1554
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Authorized Official
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Title or Position | OWNER
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Name | STEVE B PARK
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Credential | MD
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Telephone | 585-328-0153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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