Provider Demographics
NPI:1689891178
Name:THE UNITY HOSPITAL OF ROCHESTER
Entity Type:Organization
Organization Name:THE UNITY HOSPITAL OF ROCHESTER
Other - Org Name:PARK RIDGE CHEMICAL DEPENDENCY OP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT HEALTH CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-723-7185
Mailing Address - Street 1:81 LAKE AVE
Mailing Address - Street 2:EVELYN BRANDON HEALTH CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1410
Mailing Address - Country:US
Mailing Address - Phone:585-368-6900
Mailing Address - Fax:
Practice Address - Street 1:81 LAKE AVE
Practice Address - Street 2:EVELYN BRANDON HEALTH CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1410
Practice Address - Country:US
Practice Address - Phone:585-368-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE UNITY HOSPITAL OF ROCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-19
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00378721Medicaid
NY14005940OtherBLUE CHOICE
NYFA0027OtherPREFERRED CARE
NYPROtherBLUE CROSS
NY00378721Medicaid
NY330226Medicare PIN