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Organization
ROCHESTER GENERAL LONG TERM CARE, INC
Active
Organization
ROCHESTER GENERAL LONG TERM CARE, INC
Active
Other names
Hill Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MIDOLO (VICE PRESIDENT)
(585) 922-1907
Entity
Organization
Contact information
Practice address
1550 EMPIRE BLVD, WEBSTER, NY 14580-2104
(585) 617-4300
Mailing address
1550 EMPIRE BLVD, WEBSTER, NY 14580-2104
(585) 617-4300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079
BCBS
NY
01
—
CA0509
RAILROAD MEDICARE
NY
01
—
OPB334
PREFERRED CARE
NY
Enumeration date
03/06/2007
Last updated
09/21/2017
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