CONIFER PARK, INC. (NPI# 1235185612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235185612 |
| Entity Type | Organization |
| Organization Name | CONIFER PARK, INC. |
| Practice Address |
556 Clinton Ave S Rochester NY 14620-1105 |
| Mailing Address |
Po Box 417153 Boston MA 02241-7153 |
| Practice Telephone | 5854428422 |
| Mailing Telephone | 5189528140 |
| Mailing Fax Number | 5189528287 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MS. TAMMY SMITH (DIRECTOR, OP BILLING DEPT) |
| Authorized Official Telephone | 5189528408 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01420800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1150 University Ave, Suite 7, Rochester, NY 146071647 | 5854428422 | 5854428494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730379504 | Conifer Park, Inc. | Clinic/Center | 323 Lake Hill Road, Hawley Cottage, 1st Floor, Burnt Hills, NY 12027-9772 | 2007-07-27 |
| 1346296720 | Conifer Park, Inc. | Clinic/Center | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2006-05-26 |
| 1366498768 | Conifer Park, Inc. | Clinic/Center | 526 Old Liverpool Rd, Liverpool, NY 13088-6238 | 2006-05-26 |
| 1972558179 | Conifer Park, Inc. | Clinic/Center | 55 Elm St, Glens Falls, NY 12801-3549 | 2006-05-24 |
| 1356396543 | Conifer Park, Inc. | Clinic/Center | 2435 6th Ave, Troy, NY 12180-2227 | 2006-05-24 |
| 1154652709 | Conifer Park, Inc. | Substance Abuse Rehabilitation Facility | 15 Henning Rd, F. Donald Myers Education Center, Saratoga Springs, NY 12866-3749 | 2010-01-21 |
| 1336339969 | Conifer Park, Inc. | Clinic/Center | 79 Glenridge Rd, Cottage #1, Glenville, NY 12302-4523 | 2007-07-30 |
| 1366632986 | Conifer Park, Inc. | Clinic/Center | 216 Main St, Suite #2, Hudson Falls, NY 12839-1813 | 2007-07-30 |
| 1023208139 | Conifer Park, Inc. | Clinic/Center | 1051 Dix Ave, Buildings E and G, 1st Floors, Hudson Falls, NY 12839-1053 | 2007-07-26 |
| 1649225897 | Conifer Park, Inc. | Clinic/Center | 600 Franklin St, Schenectady, NY 12305-2100 | 2006-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CONIFER PARK, INC. | 79 Glenridge Road, Glenridge, Ny 12302 |
| Street Address |
556 CLINTON AVE S |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14620-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010662 | Leah Newman | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2020-07-08 |
| 1356974497 | Lisa Giglia | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2020-02-18 |
| 1538704788 | Timothy Stevens | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2019-11-12 |
| 1740831254 | Eric Haines | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2019-09-25 |
| 1275091266 | Jeannette Judith Sampson | Registered Nurse | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2019-03-08 |
| 1427529585 | Jeremy Patrick Thayer | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-12-16 |
| 1780155457 | Nicole Renee Miller | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-12-06 |
| 1790278117 | Margo Anne Tremaine | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-06-11 |
| 1982195186 | Estelle Webster | Registered Nurse | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-05-23 |
| 1396249405 | Courtney Wachter | Counselor | 556 Clinton Ave S, Rochester, NY 14620-1105 | 2018-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974174 | Linda D Pratt | Speech-Language Pathologist | Rochester Hearing and Speech Center, 1000 Elmwood Ave Suite 400, Rochester, NY 14620 | 2020-02-20 |
| 1609417617 | Maisie Katherine Pipher | Physician Assistant | 110 Crittenden Blvd, Rochester, NY 14620 | 2019-10-01 |
| 1215592332 | Allison Mckeown | Student in an Organized Health Care Education/Training Program | 777 S. Clinton Avenue - Box Hh 37, Rochester, Ny 14620, Box Hh 37, Rochester, NY 14620 | 2019-05-03 |
| 1114495736 | Tabitha Domonique Griffin | Licensed Practical Nurse | 55 Forthill Terrace, Rochester, NY 14620 | 2018-11-13 |
| 1700371960 | Deborah Paul | Dermatology | 40 Celebration Dr # 697, Rochester, NY 14620 | 2018-06-28 |
| 1942725791 | Emily Catone | Nurse Practitioner | 252 Cobb Terrace, Rochester, NY 14620 | 2017-08-12 |
| 1104355593 | Acacia Palmer | Counselor | 150 Mount Hope Avenue, Rochester, NY 14620 | 2017-06-08 |
| 1750818803 | Meagan Michelle Goates | Student in an Organized Health Care Education/Training Program | 150 Crittenden Blvd, Rochester, NY 14620 | 2017-05-20 |
| 1386170470 | Kendall Battle | Licensed Practical Nurse | 479 South Ave Apt B, Rochester, NY 14620 | 2017-05-10 |
| 1285167700 | Gina Josette Kuehn | Student in an Organized Health Care Education/Training Program | 40 Celebration Dr # 278733, Rochester, NY 14620 | 2017-04-11 |
| Find all providers in zip 14620 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.