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
800 CARTER ST, ROCHESTER, NY 14621-2604
(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
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355266
—
NY
Enumeration date
04/30/2013
Last updated
04/30/2013
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