| Lakeside Hospital Internal Medicine Group | |
|
156 West Ave Brockport NY 14420-1229 | |
| (585) 395-6095 | |
| (585) 395-6036 |
| Full Name | Lakeside Hospital Internal Medicine Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 156 West Ave, Brockport, New York |
| Authorized Official Name and Position | Rajendra Mehta (PARTNER) |
| Authorized Official Contact | 5856379196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Hospital Internal Medicine Group 156 West Ave Brockport NY 14420-1229 Ph: (585) 395-6095 | Lakeside Hospital Internal Medicine Group 156 West Ave Brockport NY 14420-1229 Ph: (585) 395-6095 |
| NPI Number | 1962555854 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962555854 | NPI | - | NPPES |
| G0181141590 | Other | NY | BLUE CROSS |
| 02198570 | Medicaid | NY | |
| MG150 | Other | NY | PREFERRED CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
State University Of New York College At Brockport Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 New Campus Dr, Hazen Hall, Brockport, NY 14420 Phone: 585-395-2414 | |
Internal Medicine At Lakeside Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 106, Brockport, NY 14420 Phone: 585-395-6095 Fax: 585-395-6084 | |
Brockport Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 34 West Ave, Brockport, NY 14420 Phone: 585-637-2161 Fax: 585-637-5819 | |
Doctor Hany G Nissiem Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6565 Fourth Section Rd, Suite 300, Brockport, NY 14420 Phone: 585-395-0620 Fax: 585-395-0622 | |
Suri Karthikeyan Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 156 West Ave, Suite 202, Brockport, NY 14420 Phone: 585-637-8580 Fax: 585-637-0471 | |
Evergreen Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4079 Lake Rd N, Brockport, NY 14420 Phone: 585-637-0151 Fax: 585-637-0562 | |
Rajendra Mehta And Leena Mehta Physicians Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 West Ave, Brockport, NY 14420 Phone: 585-637-9196 Fax: 585-637-3250 |