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) 336-1400
Entity
Organization
Contact information
Practice address
3045 EAST AVENUE, CENTRAL SQUARE HEALTH CENTER, CENTRAL SQUARE, NY 13036
(315) 676-2935
(315) 671-6976
Mailing address
800 CARTER STREET, ROCHESTER, NY 14621
(585) 339-4793
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355266
—
NY
Enumeration date
07/10/2006
Last updated
09/08/2008
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