BROCKPORT MEDICAL CARE PLLC (NPI# 1477996353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477996353 |
| Entity Type | Organization |
| Organization Name | BROCKPORT MEDICAL CARE PLLC |
| Other Organization Name | BROCKPORT ASAP MEDICAL CARE |
| Practice Address |
6565 4th Section Rd Suite 100 Brockport NY 14420-2414 |
| Mailing Address |
6565 4th Section Rd Suite 300 Brockport NY 14420-2414 |
| Practice Telephone | 5856377006 |
| Mailing Telephone | 5853950620 |
| Mailing Fax Number | 5853950622 |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |
| Authorized Official Name | HANY G NISSIEM (PRESIDENT) |
| Authorized Official Telephone | 5856377006 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
227675 | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Brockport ASAP Medical Care | Doing Business As Name - Organization |
| Street Address |
6565 4TH SECTION RD SUITE 100 |
| City | BROCKPORT |
| State | NY |
| Zip Code | 14420-2414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376848960 | Ayaz Ahmed Habib | Podiatrist | 6565 4th Section Rd, Suite 700, Brockport, NY 14420-2414 | 2011-01-13 |
| 1366876898 | Metro Footcare Associates | Podiatrist | 6565 4th Section Rd, Suite 700, Brockport, NY 14420-2414 | 2013-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194217471 | Brianna Lynn Bunch | Licensed Practical Nurse | 126 White Road, Brockport, NY 14420 | 2018-06-03 |
| 1174012785 | Penny Bowers | Massage Therapist | 27 Market Street, Upstairs, Brockport, NY 14420 | 2018-05-09 |
| 1386172062 | Allison Manly | Dentist | 1000 Transit Way, Brockport, NY 14420 | 2017-05-25 |
| 1235518143 | Erin B Chapman | Physical Medicine & Rehabilitation | 350 New Campus Drive, Brockport, NY 14420 | 2015-05-26 |
| 1972853653 | Theresa Fox Lehman | Specialist | 32 Mission Hill Drive, Brockport, NY 14420 | 2012-09-11 |
| 1689946303 | Beverly Whiteman | Registered Nurse | 40 Allen St., Brockport, NY 14420 | 2012-01-27 |
| 1316217425 | Julie Ann Knapp | Registered Nurse | 40 Allen Street, Brockport Central School District, Brockport, NY 14420 | 2012-01-05 |
| 1851678965 | Jennifer Anne Cohen | Registered Nurse | 188 Utica Street, Brockport, NY 14420 | 2011-11-03 |
| 1205088960 | Amy Maureen Hennessy | Obstetrics & Gynecology | 6668 Fourth Section Rd Ste 500, Brockport, NY 14420 | 2008-10-14 |
| 1053454884 | Nancy S Iafrati | Nurse Practitioner | Suny Brockport Student Health Center, 350 New Campus Drive, Brockport, NY 14420 | 2007-02-14 |
| Find all providers in zip 14420 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518394386 | Community Urgent Center,llc | Clinic/Center | 34 West Ave, Brockport, NY 14420-1304 | 2013-10-10 |
| 1639136153 | Lakeside Memorial Hospital Inc. | Clinic/Center | 156 West Ave, Brockport, NY 14420-1229 | 2006-04-27 |
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| 1174122923 | City Medical of Upper East Side, Pllc | Clinic/Center | 1412 Broadway, New York, NY 10018-9228 | 2020-10-22 |
| 1932708773 | City Medical of Upper East Side, Pllc | Clinic/Center | 3780 E Tremont Ave, Bronx, NY 10465-2434 | 2020-10-22 |
| 1932712049 | Lefferts Medical Associates PC | Clinic/Center | 808a Hicksville Rd, Massapequa, NY 11758-1262 | 2020-08-28 |
| 1619599578 | Rite Medical Care PC | Clinic/Center | 504 Myrtle Ave, Brooklyn, NY 11205-3542 | 2020-05-14 |
| 1649899832 | City Medical of Upper East Side, Pllc | Clinic/Center | 424 S Broadway, Yonkers, NY 10705-2301 | 2020-04-09 |
| 1902425192 | City Medical of Upper East Side, Pllc | Clinic/Center | 3494 Jerome Ave, Bronx, NY 10467-1002 | 2020-04-09 |
| 1558980748 | City Medical of Upper East Side, Pllc | Clinic/Center | 10202 Liberty Ave, Ozone Park, NY 11417-1727 | 2020-04-09 |
| 1548889736 | City Medical of Upper East Side, Pllc | Clinic/Center | 22405 Jamaica Ave, Queens Village, NY 11428-2019 | 2020-04-09 |
| 1851924294 | Tbhc Medical Services PC | Clinic/Center | 514 Fulton Street, Brooklyn, NY 11201 | 2020-02-13 |
| Find all providers with the same taxonomy | ||||
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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.