| Crystal Springs Medical Pc | |
|
6101 Robinson Rd Lockport NY 14094-8920 | |
| (716) 625-9851 | |
| (716) 625-9858 |
| Full Name | Crystal Springs Medical Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6101 Robinson Rd, Lockport, New York |
| Authorized Official Name and Position | Edgar B. Bassig (PRESIDENT) |
| Authorized Official Contact | 7166259851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Springs Medical Pc 6101 Robinson Rd Lockport NY 14094-8920 Ph: (716) 625-9851 | Crystal Springs Medical Pc 6101 Robinson Rd Lockport NY 14094-8920 Ph: (716) 625-9851 |
| NPI Number | 1295756286 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 03/21/2012 |
| Medicare PECOS PAC ID | 1658285994 |
|---|---|
| Medicare Enrollment ID | O20031119000443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295756286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 197593 (New York) | Primary |
| Provider Name | Edgar B Bassig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205891306 PECOS PAC ID: 8325952674 Enrollment ID: I20120229000146 |
| Provider Name | Merlie Mercado-quinones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346679701 PECOS PAC ID: 4981836491 Enrollment ID: I20140416001338 |
| Provider Name | Andrea A Bassig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205411881 PECOS PAC ID: 1153705850 Enrollment ID: I20220830001533 |
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