MEDICARE: LINDSAY HOUSE SURGERY CENTER LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center	2701232R	NY

General Provider Information

NPI Number	:	1780791798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDSAY HOUSE SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	973 EAST AVE
Second Line	:	SUITE 101
City	:	ROCHESTER
State	:	NY
Zip	:	14607-2216
Country	:	US
Telephone Number	:	585-244-1000
Fax Number	:	585-271-4786

Provider Business Practice Location Address
First Line	:	973 EAST AVE
Second Line	:	SUITE 101
City	:	ROCHESTER
State	:	NY
Zip	:	14607-2216
Country	:	US
Telephone Number	:	585-244-1000
Fax Number	:	585-271-4786

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	KATHERINE M SHERIDAN
Credential	:	RN, BSN
Telephone Number	:	585-244-1000

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	12/29/2016

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