Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
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
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
Mailing address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
225100000X
Physical Therapist
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9614
GROUP NUMBER BCBS
NY
Enumeration date
03/16/2007
Last updated
09/11/2025
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