Organization
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Active
Other names
Lifetime Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA AMBRES MD,MS (PRESIDENT)
(716) 857-6191
Entity
Organization
Contact information
Practice address
151 ELMVIEW AVE, PHARMACY, HAMBURG, NY 14075-3762
(716) 648-3040
(716) 656-4234
Mailing address
151 ELMVIEW AVE, PHARMACY, HAMBURG, NY 14075-3762
(716) 648-3040
(716) 656-4234
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
027326
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02619510
—
NY
01
—
027326
NYS LICENSE NUMBER
NY
01
—
3378747
NCPDP
NY
Enumeration date
09/25/2006
Last updated
08/22/2020
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