| Mary M. Gooley Hemophilia Center Inc | |
|
1415 Portland Ave Suite 500 Rochester NY 14621-3038 | |
| (585) 922-5700 | |
| (585) 922-5775 |
| Full Name | Mary M. Gooley Hemophilia Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1415 Portland Ave, Rochester, New York |
| Authorized Official Name and Position | Tom Wilmarth (PRESIDENT/CEO) |
| Authorized Official Contact | 5859225700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary M. Gooley Hemophilia Center Inc 1415 Portland Ave Ste 500 Rochester NY 14621-3043 Ph: (585) 922-5700 | Mary M. Gooley Hemophilia Center Inc 1415 Portland Ave Suite 500 Rochester NY 14621-3038 Ph: (585) 922-5700 |
| NPI Number | 1568428621 |
|---|---|
| Provider Enumeration Date | 04/25/2006 |
| Last Update Date | 03/02/2021 |
| Medicare PECOS PAC ID | 8325225527 |
|---|---|
| Medicare Enrollment ID | O20110615000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568428621 | NPI | - | NPPES |
| 000921985001 | Other | NY | BCWNY/HEALTHNOW |
| 103346CJ | Other | NY | PREFERRED CARE |
| 00355284 | Medicaid | NY | |
| 014005944 | Other | NY | BLUE CHOICE |
| 50 | Other | NY | BLUE CROSS |
| 5643168 | Other | NY | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 33D0705405 (New York) | Primary |
| Provider Name | Gregory Clayton Connolly |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1760590756 PECOS PAC ID: 4789785882 Enrollment ID: I20070719000286 |
| Provider Name | Farhan S Imran |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518133875 PECOS PAC ID: 2062586928 Enrollment ID: I20080811000617 |
| Provider Name | Saad Jamshed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659522662 PECOS PAC ID: 3274683131 Enrollment ID: I20090615000574 |
| Provider Name | Peter A Kouides |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780638775 PECOS PAC ID: 3678616232 Enrollment ID: I20100204000139 |
| Provider Name | Ronald Lewis Sham |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1235178500 PECOS PAC ID: 9739222837 Enrollment ID: I20100211000092 |
| Provider Name | Pradyumna D Phatak |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467407213 PECOS PAC ID: 4880729458 Enrollment ID: I20100322000294 |
| Provider Name | Mehul P Patel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1528277993 PECOS PAC ID: 2668504978 Enrollment ID: I20100722000616 |
| Provider Name | Robin Marie Reid |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356583355 PECOS PAC ID: 2062724180 Enrollment ID: I20150702000975 |
| Provider Name | Tara Veith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154015162 PECOS PAC ID: 8921440678 Enrollment ID: I20240525000011 |
Jeffrey A Liberman Do Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 485 Titus Ave Ste H, Rochester, NY 14617 Phone: 585-544-5368 Fax: 585-287-5304 | |
Brown Square Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 322 Lake Ave, Brown Square Center, Rochester, NY 14608 Phone: 585-254-6480 Fax: 585-254-1092 | |
Diabetes Prevention Recognition Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2655 Ridgeway Ave Ste 220, Rochester, NY 14626 Phone: 585-368-6542 Fax: 585-368-4373 | |
Rekhi & Rekhi Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1561 Long Pond Rd, Suite 411, Rochester, NY 14626 Phone: 585-426-9930 Fax: 585-426-6242 | |
Highland Hospital Of Rochester Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 South Ave, Rochester, NY 14620 Phone: 585-341-6895 Fax: 585-341-8401 | |
Joy Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 918 N Goodman St, Rochester, NY 14609 Phone: 585-697-0004 Fax: 585-697-0046 | |
Adult Complex Care Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Culver Rd, Rochester, NY 14609 Phone: 585-276-7900 Fax: 585-275-2352 |