LAKESIDE MEMORIAL HOSPITAL INC. (NPI# 1922144328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922144328 |
| Entity Type | Organization |
| Organization Name | LAKESIDE MEMORIAL HOSPITAL INC. |
| Other Organization Name | GENESEE FAMILY PRACTICE |
| Practice Address |
8745 Lake Street Rd Le Roy NY 14482-9344 |
| Practice Telephone | 5857682620 |
| Practice Fax Number | 5857682694 |
| Mailing Telephone | 5857682620 |
| Mailing Fax Number | 5857682694 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2010-07-13 |
| Authorized Official Name | DR. VLADIMIR GASPAR (PHYSICIAN) |
| Authorized Official Telephone | 5857682620 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKESIDE MEMORIAL HOSPITAL INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| GENESEE FAMILY PRACTICE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740504141 | Lakeside Memorial Hospital Inc. | Specialist | 156 West Ave, Brockport, NY 14420-1229 | 2010-03-15 |
| 1316260623 | Lakeside Memorial Hospital Inc. | Orthopaedic Surgery | 156 West Ave, Brockport, NY 14420-1229 | 2010-03-02 |
| 1609109925 | Lakeside Memorial Hospital Inc. | Emergency Medicine | 156 West Ave, Brockport, NY 14420-1229 | 2009-09-18 |
| 1730392929 | Lakeside Memorial Hospital Inc. | General Acute Care Hospital | 80 West Ave, Suite 209, Brockport, NY 14420-1322 | 2007-05-07 |
| 1942359989 | Lakeside Memorial Hospital Inc. | General Practice | 156 West Ave, Brockport, NY 14420 | 2007-01-09 |
| 1972522670 | Lakeside Memorial Hospital Inc. | Specialist | 156 West Ave, Suite 104, Brockport, NY 14420-1229 | 2006-07-19 |
| 1639136153 | Lakeside Memorial Hospital Inc. | Clinic/Center | 156 West Ave, Brockport, NY 14420-1229 | 2006-04-27 |
| Street Address |
8745 LAKE STREET RD |
| City | LE ROY |
| State | NY |
| Zip Code | 14482-9344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003888298 | George Robert Vito | Podiatrist | 8745 Lake Street Rd, Le Roy, NY 14482 | 2006-02-02 |
| 1740839919 | Surgical Centers of Western New York | Podiatrist | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2019-09-10 |
| 1356806905 | Ankle and Foot Centers of Western New York | Podiatrist | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2019-02-07 |
| 1467711135 | Andrea Naomi Kudel | Family Medicine | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2012-05-15 |
| 1013274638 | Kellyrose Mary Nichols | Family Medicine | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2012-04-20 |
| 1033188610 | Thomas P. Urschel | Physician Assistant | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079739 | Eileen Campbell | Speech-Language Pathologist | 80 Munsonst., Leroy, NY 14482 | 2018-10-19 |
| 1578911921 | Leroy Manor | Assisted Living Facility | 8678 Lake Street Road, Leroy, NY 14482 | 2016-05-26 |
| 1710318571 | Sawhney and Padmanabha Family Dentistry | Dentist | 20 Lake St., Leroy, NY 14482 | 2013-12-04 |
| 1013291301 | Brandie Sue Rogoyski | Speech-Language Pathologist | 2-6 Trigon Park, Leroy, NY 14482 | 2011-10-05 |
| 1215127816 | Anthony J. Gugino Dds PC | Dentist | 21 Main St., Le Roy, NY 14482 | 2007-07-30 |
| 1013034305 | Lisa Anne Main | Massage Therapist | 15 Bank St, Leroy, NY 14482 | 2007-03-23 |
| 1467520155 | Eric L Gahagan | Physical Therapist | 3 West Avenue, Le Roy, NY 14482 | 2006-12-01 |
| 1740369016 | Anil K Sawhney | Dentist | 20 Lake Street, Leroy, NY 14482 | 2006-11-06 |
| 1952480923 | Providence Volunteer Ambulance Corps Inc | Ambulance | 7177 Fishhouse Rd, Galway, NY 14482 | 2006-11-02 |
| 1437253986 | Marcella L Saeva | Pharmacist | 9556 Warsaw Road, Leroy, NY 14482 | 2006-09-12 |
| Find all providers in zip 14482 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598781577 | Srirat Temiyasathit | Family Medicine | 911 S Chestnut St, Le Roy, IL 61752-1894 | 2006-07-14 |
| 1467711135 | Andrea Naomi Kudel | Family Medicine | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2012-05-15 |
| 1013274638 | Kellyrose Mary Nichols | Family Medicine | 8745 Lake Street Rd, Le Roy, NY 14482-9344 | 2012-04-20 |
| 1043519515 | Andrea Belen Judkins | Family Medicine | 127 W Main St, Le Roy, NY 14482 | 2011-03-22 |
| 1386660355 | Brenda A. Kube | Family Medicine | 911 S Chestnut St, Le Roy, IL 61752-1894 | 2006-07-14 |
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| 1174122980 | Richmond Health Partners Ipa LLC | Family Medicine | 1161 Victory Blvd, Staten Island, NY 10301-3621 | 2020-10-22 |
| 1730787128 | Michael C Secallus | Family Medicine | 66 Kirkwood Gdns, Kirkwood, NY 13795-1623 | 2020-10-16 |
| 1861099053 | Julia Gross Family Health Nurse Practitioner, Pllc | Family Medicine | 950 Route 146 Ste 100, Clifton Park, NY 12065-3667 | 2020-10-01 |
| 1013523190 | Steinway Hope Medical LLC | Family Medicine | 8829 54th Ave Fl 2, Elmhurst, NY 11373-4543 | 2020-09-23 |
| 1538774500 | Jenny Brandt | Family Medicine | 3048 Sunset Ln # 2, Schenectady, NY 12303-5528 | 2020-09-15 |
| 1992319016 | Sarah Glaser | Family Medicine | 30 W 24th St, New York, NY 10010-3207 | 2020-09-04 |
| 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.