Provider Demographics
NPI:1316026149
Name:GENESEE VALLEY ANESTHESIOLOGISTS
Entity Type:Organization
Organization Name:GENESEE VALLEY ANESTHESIOLOGISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-370-8240
Mailing Address - Street 1:141 VERSTREET DR.
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4105
Mailing Address - Country:US
Mailing Address - Phone:585-730-8240
Mailing Address - Fax:585-730-8311
Practice Address - Street 1:980 WESTFALL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2605
Practice Address - Country:US
Practice Address - Phone:585-730-8240
Practice Address - Fax:585-730-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1316026149OtherPREFERRED CARE
NY6532OtherROCH BS
NY0187640590OtherBLUE CHOICE
NY01610640Medicaid
NY6532OtherROCH BS