MEDICARE: STRONG MEDICAL GROUP

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
1	208000000X	Pediatrics Physician
2	207Q00000X	Family Medicine Physician

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	:	1184664948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRONG MEDICAL GROUP

Provider Business Mailing Address
First Line	:	135 CORPORATE WOODS STE 200C
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-1459
Country	:	US
Telephone Number	:	585-784-7848
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-1448
Country	:	US
Telephone Number	:	585-279-4800
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR OF FINANCE URMFG
Name	:	JILL M HETTERICH
Credential	:
Telephone Number	:	585-756-4008

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/09/2022

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Directions to “STRONG MEDICAL GROUP ” Practice Location

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