Organization
GENESIS PEDIATRICS, LLC
Active
Other names
Genesis Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE A GOODFELLOW M.D. (MEMBER/OWNER)
(585) 426-4100
Entity
Organization
Contact information
Practice address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 426-3701
Mailing address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 426-3701
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00188076590
AETNA US HEALTHCARE
—
05
—
01414680
—
NY
01
—
161328076
TRICARE REGION 1
—
Enumeration date
09/20/2006
Last updated
02/05/2015
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