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Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Active
Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH CARLASCIO (VICE PRESIDENT REGIONAL OPERATIONS)
(585) 336-4841
Entity
Organization
Contact information
Practice address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
(585) 336-4845
Mailing address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0185419597
GROUP NUMBER FOR BILLING
NY
Enumeration date
01/18/2007
Last updated
09/11/2025
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