Organization
GREATER ROCHESTER NEUROLOGICAL ASSOCIATES, PC
Active
Other names
Greater Rochester Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE CORDOVA (PRACTICE ADMINISTRATOR)
(585) 546-3265
Entity
Organization
Contact information
Practice address
2101 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5643
(585) 546-3265
(585) 232-5158
Mailing address
2101 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5643
(585) 546-3265
(585) 232-5158
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009552
NYS LICENSE
NY
01
—
011640
NYS LICENSE
NY
05
—
01642644
—
NY
05
—
02785486
—
NY
05
—
02909722
—
NY
05
—
03974898
—
NY
05
—
04899634
—
NY
01
—
11990F
MEDICARE
NY
01
—
1400028666
MEDICARE
NY
01
—
199685-1
NYS LICENSE
NY
01
—
231421
NYS LICENSE
NY
01
—
245745
NYS LICENSE
NY
01
—
P98714
MEDICARE
NY
01
—
RB0576
MEDICARE
NY
01
—
RB8433
MEDICARE
NY
01
—
RB8434
MEDICARE
NY
Enumeration date
05/25/2006
Last updated
06/16/2022
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