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LAKESHORE SURGICAL PRACTICE PC NPI 1578998696


NPI Information

NPI: 1578998696
Provider Name: LAKESHORE SURGICAL PRACTICE, PC
Classification: Surgery - 2086S0102X
Entity Type: Organization

Specialization: Surgical Critical Care

Address:
30 ERIE CANAL DR
SUITE E
ROCHESTER, NY
ZIP 14626
Phone: (585) 637-2930
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LAKESHORE SURGICAL PRACTICE, PC is a surgical critical care surgery in Rochester, NY. The provider is 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. LAKESHORE SURGICAL PRACTICE, PC NPI is 1578998696. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

30 ERIE CANAL DR
SUITE E
ROCHESTER, NY
ZIP 14626-604
Phone: (585) 637-2930
Fax: (585) 637-2930

The provider's authorized official is Richard J King .
The authorized official title is Physician and has the following contact phone number (585) 637-2930.

The enumeration date for this NPI number is 9/9/2013 and was last updated on 9/9/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0102XSurgerySurgical Critical Care239232NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1171539MEDICARE UPINNEW YORK
2J300058709MEDICARE PINNEW YORK
302752716MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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