Provider Demographics
NPI:1669519005
Name:SIDNEY HILLMAN HEALTH CENTER OF ROCHESTER
Entity type:Organization
Organization Name:SIDNEY HILLMAN HEALTH CENTER OF ROCHESTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRIPPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-242-7589
Mailing Address - Street 1:750 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2100
Mailing Address - Country:US
Mailing Address - Phone:585-473-2000
Mailing Address - Fax:585-473-3309
Practice Address - Street 1:750 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2100
Practice Address - Country:US
Practice Address - Phone:585-473-2000
Practice Address - Fax:585-473-3309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11101BMedicare PIN