Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH CARLASCIO (VICE PRESIDENT REGIONAL OPERATIONS)
(585) 336-4841
Entity
Organization
Contact information
Practice address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
(585) 336-4845
Mailing address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 338-1400
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0185419595
GROUP NUMBER FOR BILLING
NY
Enumeration date
01/18/2007
Last updated
08/22/2020
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