Organization · Type 2 NPI

Anthony L. Jordan Health Corporation

Federally Qualified Health Center (FQHC) · Canandaigua, NY

NPI number 1649529678 Active

Practice location

120 N Main St, Suite 11
Canandaigua, NY 14424-1258

Call (585) 396-6980 Map

Mailing address

82 Holland Street
Rochester, NY 14605-2131

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Kimberlie Noyes, RNFamily Nurse Practitioner Canandaigua, NY NPI 1700429461

NPI record

NPI: 1649529678
Entity type: Organization (Type 2)
Issued: Sep 6, 2012
Last updated: Sep 7, 2012
Status: Active
Subpart: Yes of Anthony L. Jordan Health Corporation

Other names

<unavail>
Jordan at Ccia · doing business as

Authorized official

Bridgette Wiefling, MD
President/ceo
(585) 423-2878

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1649529678

Anthony L. Jordan Health Corporation's National Provider Identifier is 1649529678, issued on Sep 6, 2012. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Canandaigua, NY. The record was last updated on Sep 7, 2012.