Genesee Vascular Laboratory, Inc.

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Legal business name

GENESEE VASCULAR LABORATORY, INC.

Practice address

2060 Fairport Nine Mile Point Rd
Suite 400
Penfield, NY 14526-1749

Phone

(585) 454-6610

NPI assigned

May 3, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas E Penn, M.D.NPI 1700802832

Title

Owner/Director

Phone

(585) 454-6610

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas E Penn, MD

  • Specialist
  • Rochester, NY
  • NPI 1700802832
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1003175563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 WESTFALL RD STE B100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182628",
            "telephone_number": "585-454-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 FAIRPORT NINE MILE POINT RD",
            "address_2": "SUITE 400",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261749",
            "telephone_number": "585-454-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VASCULAR LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "585-454-6610",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03158289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenya Joniece Gavin
• Jennifer Sue Gayle
• Timothy Gerard Geen, M.D.
• Krista Gehm, PT, DPT
• Genesee Valley Obstetrics & Gynecology, P.C.
• Richard J Gensheimer, DPM
• Derrick Alexis German, MD
• Jane Elizabeth Giarrizzo, LCSW-R, ACSW, OSW-C
• Laura E Gift
• Ellie Gillam, LMSW

• Other Specialist/Technologist in Penfield, NY
• Providers in Penfield, NY by specialty
• Other Specialist/Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.