| Doctor Hany G Nissiem Family Medicine Pllc | |
|
6565 Fourth Section Rd Suite 300 Brockport NY 14420-2414 | |
| (585) 395-0620 | |
| (585) 395-0622 |
| Full Name | Doctor Hany G Nissiem Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 6565 Fourth Section Rd, Brockport, New York |
| Authorized Official Name and Position | Hany Nissiem (OWNER) |
| Authorized Official Contact | 5853950620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor Hany G Nissiem Family Medicine Pllc 6565 Fouth Section Rd Suite 300 Brockport NY 14420-2416 Ph: (585) 395-0620 | Doctor Hany G Nissiem Family Medicine Pllc 6565 Fourth Section Rd Suite 300 Brockport NY 14420-2414 Ph: (585) 395-0620 |
| NPI Number | 1184670283 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/03/2017 |
| Medicare PECOS PAC ID | 8325080526 |
|---|---|
| Medicare Enrollment ID | O20050527000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184670283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 227675 (New York) | Primary |
| Provider Name | Hany G Nissiem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295782399 PECOS PAC ID: 6406754183 Enrollment ID: I20031219000705 |
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