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Organization

WESTSIDE HEALTH SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE J. DONOHUE M.D. (MEDICAL DIRECTOR)
(585) 436-3040
Entity
Organization

Contact information

Practice address
322 LAKE AVE, ROCHESTER, NY 14608-1017
(585) 254-6480
(585) 295-6009
Mailing address
480 GENESEE ST, ROCHESTER, NY 14611-3634
(585) 436-3040
(585) 295-6009

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2701220R
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00355353
NY
01
G0182661590
BLUE CHOICE OF ROCHESTER
NY
Enumeration date
09/13/2006
Last updated
10/06/2010
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