National Provider Identifier
Anthony L. Jordan Health Corporation
Anthony L. Jordan Health Corporation is listed in the NPPES registry with a primary specialty of Federally Qualified Health Center (FQHC) in Rochester, NY and a listed phone number of (585) 697-7130.
Source: public NPPES record, last updated March 19, 2012. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1437424231
- Provider Type
- Organization
- Primary Specialty
- Federally Qualified Health Center (FQHC)
- Enumeration Date
- March 13, 2012
- Last Updated
- March 19, 2012
Practice Location
- 41 Kestrel St
- Rochester, NY 14613-2120
Phone: (585) 697-7130
Mailing Address
- 82 Holland Street
- Rochester, NY 14605-2131
Authorized Official
- Name
- Dr. Bridgette Wiefling
- Title
- President/CEO
- Credentials
- MD
- Phone
- (585) 423-2878
Specialties
- Federally Qualified Health Center (FQHC) (261QF0400X)
Browse Similar Providers
See more Federally Qualified Health Center (FQHC) providers in Rochester, NY.
Open Federally Qualified Health Center (FQHC) providers in Rochester, NY
Full Record
- NPI
- 1437424231
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Anthony L. Jordan Health Corporation
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 82 Holland Street
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14605-2131
- Mailing Country
- US
- Mailing Phone
- (585) 423-5800
- Mailing Fax
- (585) 423-2806
- Practice Street Address
- 41 Kestrel St
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14613-2120
- Practice Country
- US
- Practice Phone
- (585) 697-7130
- Practice Fax
- (585) 697-7131
- Enumeration Date
- March 13, 2012
- Last Updated
- March 19, 2012
- Authorized Official Last Name
- Wiefling
- Authorized Official First Name
- Bridgette
- Authorized Official Title
- President/CEO
- Authorized Official Phone
- (585) 423-2878
- Organization Subpart
- Yes
- Parent Organization Name
- ANTHONY L. JORDAN HEALTH CORPORATION
- Parent Organization TIN
- <UNAVAIL>
- Authorized Official Name Prefix Text
- Dr.
- Authorized Official Credential Text
- MD
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Federally Qualified Health Center (FQHC) (261QF0400X)
- Other Identifiers
- 6613 (NY, Blue Cross Of Rochester), 00384969 (NY), G0187295590 (NY, Blue Choice Of Rochester), 331838 (NY, Medicare Part A), 16467A (NY, Medicare Part B)