Provider Demographics
NPI:1386743052
Name:GREECE OBSTETRICS AND GYNECOLOGY GROUP LLP
Entity type:Organization
Organization Name:GREECE OBSTETRICS AND GYNECOLOGY GROUP LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-225-6680
Mailing Address - Street 1:2337 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4111
Mailing Address - Country:US
Mailing Address - Phone:585-225-6680
Mailing Address - Fax:585-225-3472
Practice Address - Street 1:2337 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4111
Practice Address - Country:US
Practice Address - Phone:585-225-6680
Practice Address - Fax:585-225-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0994Medicare PIN