OATKA FAMILY MEDICINE P.C. (OATKA FAMILY MEDICINE) - NPI NUMBER 1609111251

Summary

Provider Name: OATKA FAMILY MEDICINE P.C. (OATKA FAMILY MEDICINE)

NPI Number: 1609111251

Clasification: Clinic/Center (261QP2300X)

Specialization: Primary Care

Address:
5619 E MAIN ST
BATAVIA, NY
ZIP 14020

Phone Number: (585) 356-6259



Detailed Information

OATKA FAMILY MEDICINE P.C. is a primary care clinic/center in Batavia, NY. The assigned NPI number for this provider is 1609111251 and is registered as an organization entity type.
The provider Other Name Is Oatka Family Medicine.

The provider's business address is:

5619 E MAIN ST
BATAVIA, NY
ZIP 14020-609
Phone: (585) 356-6259

The provider's authorized official is Brittany Lee Morse .
The authorized official title is President and has the following contact phone number (585) 201-7055.

The enumeration date for this NPI number is 12/10/2012 and was last updated on 10/1/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QP2300X Clinic/Center Primary Care Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 J100084443 OTHER NY MEDICARE PTAN

NPI Record

No. Field Name Field Value
1 NPI 1609111251
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name OATKA FAMILY MEDICINE P.C.
5 Provider Other Organization Name OATKA FAMILY MEDICINE
6 Provider Other Organization Name Type Code 5
7 Provider First Line Business Practice Location Address 5619 E MAIN ST
8 Provider Business Practice Location Address City Name BATAVIA
9 Provider Business Practice Location Address State Name NY
10 Provider Business Practice Location Address Postal Code 140209609
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 5853566259
13 Provider Enumeration Date 12/10/2012
14 Last Update Date 10/1/2013
15 Authorized Official Last Name MORSE
16 Authorized Official First Name BRITTANY
17 Authorized Official Middle Name LEE
18 Authorized Official Title or Position PRESIDENT
19 Authorized Official Telephone Number 5852017055
20 Healthcare Provider Taxonomy Code 1 261QP2300X
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 J100084443
23 Other Provider Identifier Type Code 1 01
24 Other Provider Identifier State 1 NY
25 Other Provider Identifier Issuer 1 MEDICARE PTAN
26 Is Organization Subpart N
27 Authorized Official Name Prefix Text DR.
28 Authorized Official Credential Text M.D.

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.