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Organization

GENESEE VALLEY GROUP HEALTH ASSOCIATION

Active
Parent organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Other names
Lifetime Health Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Authorized official
MRS. DEBORAH CARLASCIO (VICE PRESIDENT OF OPERATIONS)
(585) 389-6066
Entity
Organization

Contact information

Practice address
1850 BRIGHTON HENRIETTA TOWN LINE RD, ROCHESTER, NY 14623-2532
(585) 338-1200
Mailing address
333 BUTTERNUT DR, 3RD FLOOR ATTN: TONI RADLEY, SYRACUSE, NY 13214-2141
(315) 671-6951
(315) 671-6976

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00355266
NY
Enumeration date
02/03/2014
Last updated
02/03/2014
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