GENESEE VASCULAR LABORATORY INC. NPI 1003175563

NPI Information

NPI: 1003175563
Provider Name: GENESEE VASCULAR LABORATORY, INC.
Classification: Specialist/Technologist, Other - 246Z00000X
Entity Type: Organization
Address:
2060 FAIRPORT NINE MILE POINT RD
SUITE 400
PENFIELD, NY
ZIP 14526
Phone: (585) 454-6610
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GENESEE VASCULAR LABORATORY, INC. is a specialist technologist other in Penfield, NY. The provider is general classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. GENESEE VASCULAR LABORATORY, INC. NPI is 1003175563. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2060 FAIRPORT NINE MILE POINT RD
SUITE 400
PENFIELD, NY
ZIP 14526-749
Phone: (585) 454-6610

The provider's authorized official is Thomas E Penn .
The authorized official title is Owner/director and has the following contact phone number (585) 454-6610.

The enumeration date for this NPI number is 5/3/2012 and was last updated on 7/30/2012.

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	246Z00000X	Specialist/Technologist, Other				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	03158289	MEDICAID	NEW YORK

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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