# PREMISE HEALTH OF NEW YORK MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Henkel Geneva Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952995375
- **Authorized official:** DR. JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 300 FORGE AVE, GENEVA, NY 14456-1257
- **Practice address phone:** (315) 781-9355
- **Practice address fax:** (315) 410-5626
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/25/2021
- **Last updated:** 08/16/2022