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CROOKED LAKE FAMILY MEDICINE NPI 1992946891


NPI Information

NPI: 1992946891
Provider Name: CROOKED LAKE FAMILY MEDICINE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1930 PRE EMPTION RD
PENN YAN, NY
ZIP 14527
Phone: (315) 536-0086
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CROOKED LAKE FAMILY MEDICINE is a family medicine in Penn Yan, NY. The provider is 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. CROOKED LAKE FAMILY MEDICINE NPI is 1992946891. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1930 PRE EMPTION RD
PENN YAN, NY
ZIP 14527-641
Phone: (315) 536-0086
Fax: (315) 536-4107

The provider's authorized official is Lisa Walk-reinard .
The authorized official title is Owner and has the following contact phone number (315) 536-0086.

The enumeration date for this NPI number is 3/23/2009 and was last updated on 3/23/2009.


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
1207Q00000XFamily Medicine209529NEW 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H09608MEDICARE UPIN

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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