MEDICARE: FINGER LAKES COMMUNITY HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261QA0005X	Ambulatory Family Planning Facility
3	171M00000X	Case Manager/Care Coordinator
4	1223G0001X	General Practice Dentistry
5	1041C0700X	Clinical Social Worker
6	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114198819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FINGER LAKES COMMUNITY HEALTH

Provider Business Mailing Address
First Line	:	14 MAIDEN LN
Second Line	:	PO BOX 423
City	:	PENN YAN
State	:	NY
Zip	:	14527-1208
Country	:	US
Telephone Number	:	315-531-9102
Fax Number	:	315-531-9103

Provider Business Practice Location Address
First Line	:	60 MAIN ST.
Second Line	:
City	:	PORT BYRON
State	:	NY
Zip	:	13140-0359
Country	:	US
Telephone Number	:	315-776-9700
Fax Number	:	315-776-9700

Authorized Official
Title or Position	:	CEO
Name	:	MARY ZELAZNY
Credential	:
Telephone Number	:	315-531-9102

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	02/05/2026

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