| Lakeside Medical Practice Pllc | |
|
133 E Fairmount Ave Lakewood NY 14750-1948 | |
| (716) 526-1183 | |
| (716) 526-1165 |
| Full Name | Lakeside Medical Practice Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 133 E Fairmount Ave, Lakewood, New York |
| Authorized Official Name and Position | Alicia Snow (CEO) |
| Authorized Official Contact | 7164995464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Medical Practice Pllc Po Box 405 Lakewood NY 14750-0405 Ph: (716) 526-1183 | Lakeside Medical Practice Pllc 133 E Fairmount Ave Lakewood NY 14750-1948 Ph: (716) 526-1183 |
| NPI Number | 1518720291 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518720291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Cummins Health Center-jamestown Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4720 Baker Street Ext, Lakewood, NY 14750 Phone: 716-456-2334 Fax: 716-456-2628 |