National Provider Identifier
Mary M. Gooley Hemophilia Center Inc
Mary M. Gooley Hemophilia Center Inc is listed in the NPPES registry with a primary specialty of Clinic/Center in Rochester, NY and a listed phone number of (585) 922-5700.
Profile Overview
- NPI
- 1568428621
- Provider Type
- Organization
- Primary Specialty
- Clinic/Center
- Enumeration Date
- April 25, 2006
- Last Updated
- March 02, 2021
Practice Location
- 1415 Portland Ave
- Suite 500
- Rochester, NY 14621-3038
Phone: (585) 922-5700
Mailing Address
- 1415 Portland Ave Ste 500
- Rochester, NY 14621-3043
Specialties
- Clinic/Center (261Q00000X)
Full Record
- NPI
- 1568428621
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Mary M. Gooley Hemophilia Center Inc
- Mailing Street Address
- 1415 Portland Ave Ste 500
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-3043
- Mailing Country
- US
- Mailing Phone
- (585) 922-5700
- Mailing Fax
- (585) 922-5775
- Practice Street Address
- 1415 Portland Ave
- Practice Address Line 2
- Suite 500
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3038
- Practice Country
- US
- Practice Phone
- (585) 922-5700
- Practice Fax
- (585) 922-5775
- Enumeration Date
- April 25, 2006
- Last Updated
- March 02, 2021
- Authorized Official Last Name
- Wilmarth
- Authorized Official First Name
- Tom
- Authorized Official Title
- President/CEO
- Authorized Official Phone
- (585) 922-5700
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mr.
- Certification Date
- March 02, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinic/Center (261Q00000X)
- Other Identifiers
- 000921985001 (NY, Bcwny/Healthnow), 103346CJ (NY, Preferred Care), 00355284 (NY), 014005944 (NY, Blue Choice), 50 (NY, Blue Cross), 5643168 (NY, Aetna)