| Anthony L. Jordan Health Corporation | |
|
82 Holland St Rochester NY 14605-2131 | |
| (585) 423-2816 | |
| (585) 423-2853 |
| Full Name | Anthony L. Jordan Health Corporation |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 82 Holland St, Rochester, New York |
| Authorized Official Name and Position | Yaditsy Cantero (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5854232853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony L. Jordan Health Corporation 82 Holland St Rochester NY 14605-2131 Ph: (585) 423-2816 | Anthony L. Jordan Health Corporation 82 Holland St Rochester NY 14605-2131 Ph: (585) 423-2816 |
| NPI Number | 1639621709 |
|---|---|
| Provider Enumeration Date | 10/25/2016 |
| Last Update Date | 10/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639621709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 194379 (New York) | Primary |
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