Provider Demographics
NPI:1588903090
Name:MONROE COUNTY HEALTH DEPT CLINICS
Entity type:Organization
Organization Name:MONROE COUNTY HEALTH DEPT CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CIVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHREITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-753-6664
Mailing Address - Street 1:111 WESTFALL RD RM 356
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4647
Mailing Address - Country:US
Mailing Address - Phone:585-753-6664
Mailing Address - Fax:
Practice Address - Street 1:451 E HENRIETTA RD FL 2
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4629
Practice Address - Country:US
Practice Address - Phone:585-753-6664
Practice Address - Fax:585-753-6903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONROE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355293Medicaid