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NPI Code Detail

MEDICARE: LIFETIME HEALTH MED GRP

MEDICARE: LIFETIME HEALTH MED GRP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy017164NY
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23371678OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1073557823
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFETIME HEALTH MED GRP
Provider Business Mailing Address
First Line : 1850 BRIGHTON HENRIETTA TL RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2532
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1850 BRIGHTON HENRIETTA TL RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2532
Country : US
Telephone Number : 585-292-8400
Fax Number : 585-292-6598
Authorized Official
Title or Position : PRESIDENT
Name : CYNTHIA AMBRES
Credential : MD
Telephone Number : 716-857-6191
Provider Enumeration Date : 06/15/2006
Last Update Date : 09/11/2025

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Directions to “LIFETIME HEALTH MED GRP ” Practice Location

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