Organization
BLOSSOM NORTH
Active
Other names
Blossom North Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELYN L SICK NURSE PRACTITIONER (NURSE PRACTITIONER)
(585) 544-4000
Entity
Organization
Contact information
Practice address
1335 PORTLAND AVE, ROCHESTER, NY 14621-2706
(585) 544-5000
Mailing address
1335 PORTLAND AVENUE, ROCHESTER, NY 14621
(585) 544-4000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
340672
NY
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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