Provider Demographics
NPI:1023375052
Name:EPILEPSY ASSOCIATION OF GREATER ROCHESTER, INC.
Entity Type:Organization
Organization Name:EPILEPSY ASSOCIATION OF GREATER ROCHESTER, INC.
Other - Org Name:EPILEPSY FOUNDATION OF ROCHESTER-SYRACUSE-BINGHAMTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER & INT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:585-442-4430
Mailing Address - Street 1:1650 SOUTH AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3091
Mailing Address - Country:US
Mailing Address - Phone:585-442-4430
Mailing Address - Fax:585-442-6305
Practice Address - Street 1:1650 SOUTH AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3091
Practice Address - Country:US
Practice Address - Phone:585-442-4430
Practice Address - Fax:585-442-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable