| Lifetime Health Medical Group | |
|
800 Carter St Rochester NY 14621-2604 | |
| (585) 338-1400 | |
| (585) 336-4845 |
| Full Name | Lifetime Health Medical Group |
|---|---|
| Speciality | Pediatrics |
| Location | 800 Carter St, Rochester, New York |
| Authorized Official Name and Position | Deborah Carlascio (VICE PRESIDENT REGIONAL OPERATIONS) |
| Authorized Official Contact | 5853364841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Health Medical Group 800 Carter St Rochester NY 14621-2604 Ph: (585) 338-1400 | Lifetime Health Medical Group 800 Carter St Rochester NY 14621-2604 Ph: (585) 338-1400 |
| NPI Number | 1417000811 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417000811 | NPI | - | NPPES |
| G0185419598 | Other | NY | GROUP NUMBER FOR BILLING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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