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Organization
SOUTHGATE MEDICAL GROUP,LLP
Active
Organization
SOUTHGATE MEDICAL GROUP,LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HOFFMAN M.D. (PRESIDENT)
(716) 712-0851
Entity
Organization
Contact information
Practice address
1026 UNION RD, WEST SENECA, NY 14224-3449
(716) 712-0851
(716) 712-0852
Mailing address
1026 UNION RD, WEST SENECA, NY 14224-3449
(716) 712-0851
(716) 712-0852
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02367504
—
NY
01
—
4748010001
DME MEDICARE
—
Enumeration date
04/27/2006
Last updated
07/27/2014
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