LAKESHORE SURGICAL PRACTICE, PC (NPI# 1578998696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578998696 |
Entity Type | Organization |
Organization Name | LAKESHORE SURGICAL PRACTICE, PC |
Practice Address |
30 Erie Canal Dr Suite E Rochester NY 14626-4604 |
Mailing Address |
1 Park Ave Brockport NY 14420-1913 |
Practice Telephone | 5856372930 |
Practice Fax Number | 5856372930 |
Mailing Telephone | 5856372930 |
Mailing Fax Number | 5855074707 |
Enumeration Date | 2013-09-09 |
Last Update Date | 2013-09-09 |
Authorized Official Name | DR. RICHARD J KING (PHYSICIAN) |
Authorized Official Telephone | 5856372930 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
239232 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 02752716 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801173448 | Lakeshore Surgical Practice, PC | Surgery | 156 West Ave, Brockport, NY 14420-1229 | 2011-11-10 |
Street Address |
30 ERIE CANAL DR SUITE E |
City | ROCHESTER |
State | NY |
Zip Code | 14626-4604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801894100 | Louis Howard Medved | Psychiatry & Neurology | 30 Erie Canal Dr, Suite G, Rochester, NY 14626-4604 | 2005-07-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760978084 | Elizabeth M Neenan | Nurse Practitioner | 105 Canal Landing Blvd. Suite 1, Rochester, NY 14626 | 2018-07-10 |
1811488737 | Anthony Richard Mesolella | Dentist | 2081 W Ridge Rd Ste 204, Rochester, NY 14626 | 2018-05-26 |
1285157370 | Heather Kate Byam | Nurse Anesthetist, Certified Registered | 280 Mill Road, Rochester, NY 14626 | 2017-07-20 |
1710415039 | Abner O De Los Santos | Dentist | 120 Erie Canal Dr Ste 150, Rochester, NY 14626 | 2017-05-31 |
1609308709 | Ulfat Shafiq | Dentist | 1100 Long Pond Rd Ste 115, Greece, NY 14626 | 2017-03-29 |
1174982953 | S.a.v.o.c L.l.c | Preferred Provider Organization | 2833 West Ridge Road, Pearle Vision Ridgemont Plaza Suite 'a', Rochester, NY 14626 | 2016-02-22 |
1700244357 | Kerri Anne Sawyer | Registered Nurse | 82 Southridge Drive, Rochester, NY 14626 | 2016-02-10 |
1518398106 | Braces of Greece | Exclusive Provider Organization | 770 Fetzner Rd., Rochester, NY 14626 | 2013-12-06 |
1477983443 | Amy Pawlyk | Licensed Practical Nurse | 116 Annie Lane, Rochester, NY 14626 | 2013-11-12 |
1689911208 | Kathleen Zimmerman | Occupational Therapist | 1555 Long Pond Rd., 4th Floor, Rochester, NY 14626 | 2013-01-16 |
Find all providers in zip 14626 |
Taxonomy Code | 2086S0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Surgical Critical Care |
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144546995 | Michael Antonio Vella | Surgery | 601 Elmwood Avenue Box Surg, Rochester, NY 14642-0001 | 2010-04-19 |
1164076691 | Kristen Giberson | Surgery | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2019-08-01 |
1366951998 | Kevin Charles Cooper | Surgery | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2017-09-27 |
1689023277 | Cardiac Surgery of The University of Rochester | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2016-06-06 |
1851754634 | Acute Care Trauma of The University of Rochester | Surgery | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2016-03-30 |
1962644484 | Neil Gupta Kumar | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2009-03-30 |
1003829110 | Yanjie Qi | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2006-08-14 |
1740205566 | University of Rochester Surgical Associates | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2006-07-13 |
1770510836 | Paul Edward Bankey | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2006-06-26 |
1417984519 | Nicole Anne Stassen-wagner | Surgery | 601 Elmwood Ave, Box Surg, Rochester, NY 14642-8410 | 2006-06-26 |
Find all providers in ROCHESTER |
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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.