Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH CARLASCIO MHA (VICE PRESIDENT OF OPERATIONS)
(585) 248-5300
Entity
Organization
Contact information
Practice address
77 SULLYS TRL, PITTSFORD, NY 14534-3754
(585) 248-5300
Mailing address
77 SULLYS TRL, PITTSFORD, NY 14534-3754
(585) 248-5300
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
2085B0100X
Body Imaging Physician
—
—
213E00000X
Podiatrist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
07/14/2006
Last updated
12/20/2016
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