Genesee Valley Group Health Association

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GENESEE VALLEY GROUP HEALTH ASSOCIATION

Doing business as

Lifetime Health Medical Group

Practice address

3045 East Avenue
Central Square Health Center
Central Square, NY 13036

Phone

(315) 676-2935

Fax

(315) 671-6976

NPI assigned

Jul 10, 2006

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deborah Carlascio

Title

Vice President Regional Operations

Phone

(585) 336-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lifetime Health Medical Group Doing business as

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1891729810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CARTER STREET",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-339-4793",
            "fax_number": "585-336-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 EAST AVENUE",
            "address_2": "CENTRAL SQUARE HEALTH CENTER",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "13036",
            "telephone_number": "315-676-2935",
            "fax_number": "315-671-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE VALLEY GROUP HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "CARLASCIO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VICE PRESIDENT REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "585-336-1400"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "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"
        }
    ]
}

• Dignity Plus, Inc
• Jennifer Homer Eckardt, MS PT
• Excel Physical Therapy
• Richard A Frio, OD
• Genesee Valley Group Health Association (Lifetime Health Medical Group)
• Lorie Giamartino, RPH
• Ladonna L Goldsmith, LCSW-R
• Rose Marie Greco, RN
• Evan Scott Gross, DDS
• Bridget Marie Grosso, OPTICIAN

• Clinic/Center in Central Square, NY
• Providers in Central Square, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.