Basic Information
Provider Information
NPI: 1619597390
EntityType: 2
ReplacementNPI:  
OrganizationName: THE UNITY HOSPITAL OF ROCHESTER
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UNITY SPECIALTY HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 89 GENESEE ST
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146113201
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 89 GENESEE ST
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146113201
CountryCode: US
TelephoneNumber: 5857237000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/22/2020
LastUpdateDate: 08/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STEWART
AuthorizedOfficialFirstName: DOUGLAS
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT HEALTH CARE SERVICE, RRH
AuthorizedOfficialTelephone: 5857237185
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: THE UNITY HOSPITAL OF ROCHESTER
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282E00000X  N HospitalsLong Term Care Hospital 
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


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