ST. PETERSBURG MEDICAL CARE LLC NPI 1437609807

NPI Information

NPI: 1437609807
Provider Name: ST. PETERSBURG MEDICAL CARE LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
225 EAST AVE
LOCKPORT, NY
ZIP 14094
Phone: (716) 438-3546
Get Directions

ST. PETERSBURG MEDICAL CARE LLC is a gynecology obstetrics gynecology in Lockport, NY. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee ST. PETERSBURG MEDICAL CARE LLC NPI is 1437609807. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

225 EAST AVE
LOCKPORT, NY
ZIP 14094-812
Phone: (716) 438-3546

The provider's authorized official is Mohamed Khalaf .
The authorized official title is Manager and has the following contact phone number (716) 438-3546.

The enumeration date for this NPI number is 10/10/2016 and was last updated on 10/10/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		202334	NEW YORK	No
2	207VG0400X	Obstetrics & Gynecology	Gynecology	202334	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	01636066	MEDICAID	NEW YORK
2	12020B	MEDICARE PIN	NEW YORK
3	F86409	MEDICARE UPIN	NEW 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: 5/5/2024

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