| Ontario Lakeside Medical Associates | |
|
90 W Utica St Oswego NY 13126 | |
| (315) 342-8552 | |
| (315) 342-8572 |
| Full Name | Ontario Lakeside Medical Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 90 W Utica St, Oswego, New York |
| Authorized Official Name and Position | Carlos O Dator (PHYSICIAN) |
| Authorized Official Contact | 3153428552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ontario Lakeside Medical Associates 90 W Utica St Oswego NY 13126-3048 Ph: (315) 342-8552 | Ontario Lakeside Medical Associates 90 W Utica St Oswego NY 13126 Ph: (315) 342-8552 |
| NPI Number | 1184645368 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 07/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184645368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 1828341 (New York) | Primary |
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