Provider First Line Business Practice Location Address:
1059 SILBEY TOWER BUILDING
Provider Second Line Business Practice Location Address:
MEDICAID SERVICE COORDINATION PROGRAM
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-454-1620
Provider Business Practice Location Address Fax Number:
585-454-6814
Provider Enumeration Date:
02/06/2007