Provider Demographics
NPI:1154482628
Name:UNIVERSITY OF ROCHESTER
Entity Type:Organization
Organization Name:UNIVERSITY OF ROCHESTER
Other - Org Name:STRONG MEMORIAL HOSPITAL PSYCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOLIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-275-3033
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 684
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0002
Mailing Address - Country:US
Mailing Address - Phone:585-784-8200
Mailing Address - Fax:585-784-8207
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 684
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0002
Practice Address - Country:US
Practice Address - Phone:585-784-8200
Practice Address - Fax:585-784-8207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ROCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-12
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2701005H273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY107237EUOtherPREFERRED CARE GERI PSYCH
NY02976543Medicaid
NY106138EUOtherPREFERRED CARE PSYCH
NY06XIOtherEXCELLUS PSYCH GERIATRIC
NY107236EUOtherPREFERRED CARE ADOL PSYCH
NY000000742001OtherBCWNY PSYCH
NY06XBOtherEXCELLUS PSYCH
NY06XZOtherEXCELLUS PSYCH ADOLES
NY06XBOtherEXCELLUS PSYCH
NY33S285Medicare Oscar/Certification