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
120 GARDENVILLE PKWY W, WEST SENECA, NY 14224-1324
(716) 668-3600
Mailing address
120 GARDENVILLE PKWY W, WEST SENECA, NY 14224-1324
(716) 668-3600
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003001856
—
NY
Enumeration date
06/09/2014
Last updated
06/09/2014
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