DR. LEO MICHAEL MICHALEK JR. (NPI# 1003801366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003801366 |
| Entity Type | Individual |
| Full Name | DR. LEO MICHAEL MICHALEK JR. |
| Credential | MD |
| Practice Address |
561 Ridge Rd Lackawanna NY 14218-1319 |
| Mailing Address |
550 Center Rd West Seneca NY 14224 |
| Practice Telephone | 7168230141 |
| Practice Fax Number | 7168225468 |
| Mailing Telephone | 7166770100 |
| Mailing Fax Number | 7166770200 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2010-05-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 094920 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UNIVERA | 00010118401 | 01 | |
| BCBS | 000505334001 | 01 | |
| IHA | 1700291 | 01 | |
| NY | 00601643 | 05 |
| Street Address |
561 RIDGE RD |
| City | LACKAWANNA |
| State | NY |
| Zip Code | 14218-1319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811419765 | Jennifer Lynn Cuneo | Nurse Practitioner | 20 Maryknoll Dr, Lackawanna, NY 14218 | 2017-07-12 |
| 1144579251 | Jennifer Jalil-contreras | Social Worker | 33 Wilkesbarre Avenue, Lackawanna, NY 14218 | 2012-09-05 |
| 1578833323 | Buffalo Synapse Support, LLC | Specialist/Technologist, Other | 609 Ridge Road, Lackawanna, NY 14218 | 2012-01-11 |
| 1851546097 | Rania Karam-bayoumi | Family Medicine | 227 Ridge Road, Lackawanna, NY 14218 | 2008-12-01 |
| 1548427552 | Jennifer Anne Molea | Specialist | 1025 Ridge Road, Lackawanna, NY 14218 | 2008-05-19 |
| 1649481904 | Richard Edwin Zambron | Dentist | 1243 Ridge Road, Lackawanna, NY 14218 | 2007-05-25 |
| 1447461876 | Baker Victory Services | Nursing Facility/Intermediate Care Facility | 180 Martin Road, Lackawanna, NY 14218 | 2007-05-25 |
| 1396956462 | Baker Victory Services | Psychiatric Residential Treatment Facility | 150 Martin Road, Lackawanna, NY 14218 | 2007-05-24 |
| 1245352921 | Baker Hall | Day Training, Developmentally Disabled Services | 650 Ridge Road, Lackawanna, NY 14218 | 2007-04-04 |
| 1730210238 | Brandi Arcara | Counselor | 2600 South Park Avenue, Parkview Center, Lackawanna, NY 14218 | 2007-03-08 |
| Find all providers in zip 14218 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780857854 | Pervez Ali Khan | General Practice | 2600 Southpark Avenue, Lackawanna, NY 14218-1504 | 2008-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420472 | Theodean Smith-lawrence | General Practice | 7 Smoke Rise Ln, Wappingers Falls, NY 12590-1220 | 2020-09-03 |
| 1891304325 | Christopher R. Page, M.d., Pllc | General Practice | 46 Route 25a Ste 6, Setauket, NY 11733-2807 | 2020-07-30 |
| 1740804442 | Aliza Hakimian | General Practice | 15 Hill Park Ave Apt 2n, Great Neck, NY 11021-3709 | 2020-05-29 |
| 1962022152 | Lynnette Lallave - Cortes | General Practice | 2 Seaman Ave Apt 1d, New York, NY 10034-2904 | 2020-04-17 |
| 1942829759 | Northeasttelemedicine | General Practice | 483 Coolidge Hill Rd, Diamond Point, NY 12824 | 2020-04-11 |
| 1578198826 | Online Care Medicine PC | General Practice | 26 Oldox Rd, Delmar, NY 12054-2943 | 2020-03-06 |
| 1821621301 | Donnet Andrea Riley | General Practice | 781 Palmer Rd Apt 3a, Bronxville, NY 10708-3309 | 2020-02-12 |
| 1104463652 | Ohad Shimshon Bentur | General Practice | 450 E 63rd St Apt 3g, New York, NY 10065-7957 | 2019-12-03 |
| 1285278291 | Echo Clinical Associates LLC | General Practice | 56 Echo Ave., Ste 1, Miller Place, NY 11764-2454 | 2019-11-01 |
| 1710528583 | Debra Heverly | General Practice | 2315 Whirlpool St # 415, Niagara Falls, NY 14305-2413 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
| City | LACKAWANNA |
| Zip Code | 14218 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.