| Brockport Internal Medicine, Pc | |
|
34 West Ave Brockport NY 14420-1304 | |
| (585) 637-2161 | |
| (585) 637-5819 |
| Full Name | Brockport Internal Medicine, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 34 West Ave, Brockport, New York |
| Authorized Official Name and Position | Pankaj Garg (PRESIDENT) |
| Authorized Official Contact | 5856372161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brockport Internal Medicine, Pc 34 West Ave Brockport NY 14420-1304 Ph: () - | Brockport Internal Medicine, Pc 34 West Ave Brockport NY 14420-1304 Ph: (585) 637-2161 |
| NPI Number | 1144434408 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8628033305 |
|---|---|
| Medicare Enrollment ID | O20041122000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144434408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 199906 (New York) | Primary |
| Provider Name | Pankaj K Garg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043269335 PECOS PAC ID: 5799740478 Enrollment ID: I20041129000328 |
| Provider Name | Nurcan Ergin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720171366 PECOS PAC ID: 8628015450 Enrollment ID: I20050413000921 |
| Provider Name | Teodoro R Mariano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477577583 PECOS PAC ID: 8921275421 Enrollment ID: I20120125000059 |
Suny Brockport Student Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 New Campus Dr, Hazen Hall, Brockport, NY 14420 Phone: 585-395-2414 | |
Internal Medicine At Lakeside Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 106, Brockport, NY 14420 Phone: 585-395-6095 Fax: 585-395-6084 | |
Doctor Hany G Nissiem Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6565 Fourth Section Rd, Suite 300, Brockport, NY 14420 Phone: 585-395-0620 Fax: 585-395-0622 | |
Suri Karthikeyan Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 202, Brockport, NY 14420 Phone: 585-637-8580 Fax: 585-637-0471 | |
Evergreen Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4079 Lake Rd N, Brockport, NY 14420 Phone: 585-637-0151 Fax: 585-637-0562 | |
Rajendra Mehta And Leena Mehta Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 West Ave, Brockport, NY 14420 Phone: 585-637-9196 Fax: 585-637-3250 |