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) 423-2816.
Profile Overview
- NPI
- 1639621709
- Provider Type
- Organization
- Primary Specialty
- Federally Qualified Health Center (FQHC)
- Enumeration Date
- October 25, 2016
- Last Updated
- October 25, 2016
Practice Location
- 82 Holland St
- Rochester, NY 14605-2131
Phone: (585) 423-2816
Specialties
- Federally Qualified Health Center (FQHC) (261QF0400X)
Full Record
- NPI
- 1639621709
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Anthony L. Jordan Health Corporation
- Mailing Street Address
- 82 Holland St
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14605-2131
- Mailing Country
- US
- Mailing Phone
- (585) 423-2816
- Mailing Fax
- (585) 423-2853
- Practice Street Address
- 82 Holland St
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14605-2131
- Practice Country
- US
- Practice Phone
- (585) 423-2816
- Practice Fax
- (585) 423-2853
- Enumeration Date
- October 25, 2016
- Last Updated
- October 25, 2016
- Authorized Official Last Name
- Cantero
- Authorized Official First Name
- Yaditsy
- Authorized Official Title
- Credentialing Specialist
- Authorized Official Phone
- (585) 423-2853
- Organization Subpart
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Federally Qualified Health Center (FQHC) (261QF0400X)