Organization
GENESEE VALLEY GROUP HEALTH ASSOCATION
Active
Organization
GENESEE VALLEY GROUP HEALTH ASSOCATION
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH CARLASCIO (VICE PRESIDENT REGIONAL OPERATIONS)
(585) 338-1400
Entity
Organization
Contact information
Practice address
130 EMPIRE DR, WEST SENECA, NY 14224-1320
(716) 668-6170
Mailing address
130 EMPIRE DR, WEST SENECA, NY 14224-1320
(716) 668-6170
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011283016
GROUP# RADIOLOGY
NY
Enumeration date
03/22/2007
Last updated
09/11/2025
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