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 OPERATION)
(585) 336-1400
Entity
Organization
Contact information
Practice address
800 CARTER ST, ROCHESTER, NY 14621-2604
(585) 336-1400
Mailing address
800 CARTER ST, ROCHESTER, NY 14621-2604
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0185419590
RADIOLOGY GROUP NUMBER
NY
Enumeration date
03/15/2007
Last updated
08/22/2020
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