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Organization
INTERNAL MEDICINE AT LAKESIDE
Active
Organization
INTERNAL MEDICINE AT LAKESIDE
Active
Parent organization
LAKESIDE MEMORIAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKESIDE MEMORIAL HOSPITAL
Authorized official
MRS. NANCY M WILSON (PHYSICIAN PRACTICES)
(585) 395-6095
Entity
Organization
Contact information
Practice address
156 WEST AVE, SUITE 106, BROCKPORT, NY 14420-1229
(585) 395-6095
(585) 395-6084
Mailing address
156 WEST AVENUE, SUITE 106, BROCKPORT, NY 14420
(585) 395-6095
(585) 395-6084
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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