Provider Demographics
NPI:1740201334
Name:FINGER LAKES VISITING NURSE SERVICE INC.
Entity type:Organization
Organization Name:FINGER LAKES VISITING NURSE SERVICE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-274-4225
Mailing Address - Street 1:756 PRE EMPTION ROAD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456
Mailing Address - Country:US
Mailing Address - Phone:315-789-9821
Mailing Address - Fax:315-789-4034
Practice Address - Street 1:756 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1336
Practice Address - Country:US
Practice Address - Phone:315-789-9821
Practice Address - Fax:315-789-4034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3402501F251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01527802Medicaid
NY01527802Medicaid