NPIMap

Organization Active NPI

Genesee Valley Group Health Association

Doing business as Lifetime Health Medical Group

  • Eyewear Supplier
  • Rochester, NY
National Provider Identifier
1073936662
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
GENESEE VALLEY GROUP HEALTH ASSOCIATION
Doing business as
Lifetime Health Medical Group
Practice address
1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2532
Phone
(585) 338-1200
NPI assigned
Feb 3, 2014
Last updated
Feb 3, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESEE VALLEY GROUP HEALTH ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Authorized official

Name
Mrs. Deborah Carlascio
Title
Vice President of Operations
Phone
(585) 389-6066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

1850 Brighton Henrietta Town Line Rd
Rochester, NY 14623-2532

Mailing address

333 Butternut Dr
3Rd Floor Attn: Toni Radley
Syracuse, NY 13214-2141
Phone (315) 671-6951

Other identifiers 1

IdentifierTypeStateIssuer
00355266MedicaidNY

Other names 1

  • Lifetime Health Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Genesee Valley Group Health Associaton52 organizations share this tax ID, including this one
Part of
Genesee Valley Group Health Associaton

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1073936662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BUTTERNUT DR",
            "address_2": "3RD FLOOR ATTN: TONI RADLEY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132142141",
            "telephone_number": "315-671-6951",
            "fax_number": "315-671-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BRIGHTON HENRIETTA TOWN LINE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232532",
            "telephone_number": "585-338-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "CARLASCIO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "585-389-6066",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355266",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.