Active NPI
Genesee Valley Group Health Association
- Clinic/Center
- Pittsford, NY
National Provider Identifier
1104842178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- GENESEE VALLEY GROUP HEALTH ASSOCIATION
- Practice address
- 77 Sullys TRL
Pittsford, NY 14534-3754 - Phone
- (585) 248-5300
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deborah Carlascio, MHA
- Title
- Vice President of Operations
- Phone
- (585) 248-5300
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | |||
| Optometrist | 152W00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Ophthalmology Physician | 207W00000X | |||
| Otolaryngology Physician | 207Y00000X | |||
| Body Imaging Physician | 2085B0100X | |||
| Podiatrist | 213E00000X | |||
| Clinic/Center | 261Q00000X | Primary | ||
| Physical Therapy Clinic/Center | 261QP2000X | |||
| Urgent Care Clinic/Center | 261QU0200X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Eyewear Supplier | 332H00000X |
Addresses
Primary practice location
77 Sullys TRL
Pittsford, NY 14534-3754
Mailing address
77 Sullys TRL
Pittsford, NY 14534-3754
Phone (585) 248-5300
Other names 1
- Lifetime Health Medical Group
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1482192000000",
"number": "1104842178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 SULLYS TRL",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "145343754",
"telephone_number": "585-248-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 SULLYS TRL",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "145343754",
"telephone_number": "585-248-5300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-14",
"last_updated": "2016-12-20",
"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": "585-248-5300",
"authorized_official_credential": "MHA"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist, Nutrition, Education",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Body Imaging",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifetime Health Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pittsford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.