| Kennedy Tower | |
|
666 Plymouth Ave S Rochester NY 14608-2766 | |
| (585) 697-7120 | |
| (585) 697-7121 |
| Full Name | Kennedy Tower |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 666 Plymouth Ave S, Rochester, New York |
| Authorized Official Name and Position | Janice Harbin (PRESIDENT/CEO) |
| Authorized Official Contact | 5854232878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Tower 82 Holland St Rochester NY 14605-2131 Ph: (585) 423-5800 | Kennedy Tower 666 Plymouth Ave S Rochester NY 14608-2766 Ph: (585) 697-7120 |
| NPI Number | 1609141316 |
|---|---|
| Provider Enumeration Date | 03/13/2012 |
| Last Update Date | 02/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609141316 | NPI | - | NPPES |
| 00384969 | Medicaid | NY | |
| 16467A | Other | NY | MEDICARE PART B |
| G0187295590 | Other | NY | BLUE CHOICE OF ROCHESTER |
| 331838 | Other | NY | MEDICARE PART A |
| 6613 | Other | NY | BLUE CROSS OF ROCHESTER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2701211R (New York) | Primary |
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