Organization
GENESEE VALLEY GROUP HEALTH
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEB CARLASCIO (VICE PRESIDENT OF OPERATIONS)
(585) 389-6066
Entity
Organization
Contact information
Practice address
1850 BRIGHTON HENRIETTA TOWN LINE RD, ROCHESTER, NY 14623-2532
(585) 424-6210
Mailing address
333 BUTTERNUT DR, SYRACUSE, NY 13214-2141
(315) 671-6951
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
06/09/2014
Last updated
06/09/2014
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