MARY M. GOOLEY HEMOPHILIA CENTER INC NPI 1568428621

NPI Information

NPI: 1568428621
Provider Name: MARY M. GOOLEY HEMOPHILIA CENTER INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1415 PORTLAND AVE
SUITE 500
ROCHESTER, NY
ZIP 14621
Phone: (585) 922-5700
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MARY M. GOOLEY HEMOPHILIA CENTER INC is a clinic center in Rochester, NY. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MARY M. GOOLEY HEMOPHILIA CENTER INC NPI is 1568428621. The provider is registered as an organization entity type.

The provider's business location address is:

1415 PORTLAND AVE
SUITE 500
ROCHESTER, NY
ZIP 14621-038
Phone: (585) 922-5700
Fax: (585) 922-5775

The provider's authorized official is Tom Wilmarth .
The authorized official title is President/ceo and has the following contact phone number (585) 922-5700.

The enumeration date for this NPI number is 4/25/2006 and was last updated on 3/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		33D0705405	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	014005944	OTHER	NEW YORK	BLUE CHOICE
2	103346CJ	OTHER	NEW YORK	PREFERRED CARE
3	50	OTHER	NEW YORK	BLUE CROSS
4	5643168	OTHER	NEW YORK	AETNA
5	00355284	MEDICAID	NEW YORK
6	000921985001	OTHER	NEW YORK	BCWNY/HEALTHNOW

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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