LAKE CHAMPLAIN OB/GYN PC NPI 1891708095

NPI Information

  • NPI: 1891708095
  • Provider Name: LAKE CHAMPLAIN OB/GYN, PC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • CLIA Number: 33D0892246
  • Address: 206 CORNELIA ST
    SUITE 306
    PLATTSBURGH, NY
    ZIP 12901
  • Phone: (518) 566-9452

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NPI Details

LAKE CHAMPLAIN OB/GYN, PC is an obstetrics gynecology in Plattsburgh, NY. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. LAKE CHAMPLAIN OB/GYN, PC NPI is 1891708095. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

206 CORNELIA ST
SUITE 306
PLATTSBURGH, NY
ZIP 12901-779
Phone: (518) 566-9452
Fax: (519) 562-7189

The provider's authorized official is Jeannie S Van Nostrand .
The authorized official title is Office Manager and has the following contact phone number (518) 566-9452.

The CLIA number assigned to this NPI record is 33D0892246 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/15/2006 and was last updated on 11/3/2014.

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
1207V00000XObstetrics & GynecologyYes

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 Other Provider Identifier Issuer
154106MEDICARE ID-TYPE UNSPECIFIEDNEW 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: 3/30/2025

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