Provider Demographics
NPI:1447393632
Name:COUNTY OF MONROE
Entity Type:Organization
Organization Name:COUNTY OF MONROE
Other - Org Name:MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACTG COMMISSIONER OF PUBLIC HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ DE BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:585-753-5327
Mailing Address - Street 1:111 WESTFALL ROAD
Mailing Address - Street 2:ROOM 976
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4647
Mailing Address - Country:US
Mailing Address - Phone:585-753-6666
Mailing Address - Fax:585-753-5115
Practice Address - Street 1:111 WESTFALL ROAD
Practice Address - Street 2:ROOM 976
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4647
Practice Address - Country:US
Practice Address - Phone:585-753-6666
Practice Address - Fax:585-753-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06000152459251K00000X
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY182563590Medicaid
NY00355293Medicaid
NY11211BMedicare UPIN