| Kevin T Le Roy, CFNP | |
|
110 W 6th St, Oswego, NY 13126-2507 | |
| (315) 349-5511 | |
| (315) 349-5732 |
| Full Name | Kevin T Le Roy |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 110 W 6th St, Oswego, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316175052 | NPI | - | NPPES |
| 03133180 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 335967 (New York) | Primary |
| 207P00000X | Emergency Medicine | 335967 (New York) | Secondary |
| Entity Name | St Joseph's Physician Health PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154376770 PECOS PAC ID: 9436041431 Enrollment ID: O20040325001159 |
| Entity Name | Oswego Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871678458 PECOS PAC ID: 4981686045 Enrollment ID: O20040602001275 |
| Entity Name | Port City Emergency Physicians LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134370547 PECOS PAC ID: 0345301917 Enrollment ID: O20081202000420 |
| Entity Name | St Josephs Medical PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942501747 PECOS PAC ID: 4688855844 Enrollment ID: O20110221000744 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin T Le Roy, CFNP 5100 W Taft Rd, Suite 1c, Liverpool, NY 13088-3807 Ph: (315) 452-2333 | Kevin T Le Roy, CFNP 110 W 6th St, Oswego, NY 13126-2507 Ph: (315) 349-5511 |
Susan P. Nalle, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 10 George St, Oswego, NY 13126 Phone: 315-342-0888 Fax: 315-343-4663 |
Miss Tammy Elizabeth Engle, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5511 |
Angela M Brown, MS, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Rudloph Rd, Oswego, NY 13126 Phone: 315-312-4100 |
Ms. Katharine Walser, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 29 E Cayuga St, Oswego, NY 13126 Phone: 315-326-4100 |
Ms. Sandra Ford, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 299 E River Rd, Oswego, NY 13126 Phone: 315-342-3166 Fax: 315-343-6531 |
Tricia R Vivlamore, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7060 State Route 104, Suny Oswego, Oswego, NY 13126 Phone: 315-312-4100 Fax: 315-312-5409 |
Mrs. Victoria Gray, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 29 E Cayuga St, Oswego, NY 13126 Phone: 315-326-4100 |