Organization
LIVINGSTON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES JOSEPH PERAINO (DEPUTY PUBLIC HEALTH DIRECTOR)
(585) 243-7270
Entity
Organization
Contact information
Practice address
4600 MILLENNIUM DR, GENESEO, NY 14454-1197
(585) 243-7250
(585) 243-7264
Mailing address
4600 MILLENNIUM DR, GENESEO, NY 14454-1197
(585) 243-7250
(585) 243-7264
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00357960
—
NY
01
—
014006252
BCBS PROVIDER NUMBER
NY
05
—
01662211
—
NY
01
—
103061EU
PREF CARE PROVIDER NUMBER
NY
01
—
LM
BCBS INDEM PROV NUMBER
NY
Enumeration date
10/02/2006
Last updated
07/31/2023
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