Provider Demographics
NPI:1407302367
Name:WEST END PEDIATRIC URGENT CARE LLC
Entity Type:Organization
Organization Name:WEST END PEDIATRIC URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:O'GARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-797-5422
Mailing Address - Street 1:1800 ENGLISH ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-1691
Mailing Address - Country:US
Mailing Address - Phone:585-286-9595
Mailing Address - Fax:585-286-9598
Practice Address - Street 1:1800 ENGLISH ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14616-1691
Practice Address - Country:US
Practice Address - Phone:585-286-9595
Practice Address - Fax:585-286-9598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207PP0204X, 208000000X, 261QU0200X
NY209616261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care