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Organization
PRIME MEDICAL OF THE FINGER LAKES PLLC
Active
Organization
PRIME MEDICAL OF THE FINGER LAKES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARBEL G MOUSSALLEM M.D. (OWNER)
(315) 663-7259
Entity
Organization
Contact information
Practice address
1150 STATE ROUTE 5 AND 20, GENEVA, NY 14456-9543
(315) 759-5319
(315) 759-5339
Mailing address
1150 STATE ROUTE 5 AND 20, GENEVA, NY 14456-9543
(315) 759-5319
(315) 759-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
232779-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03358610
—
NY
Enumeration date
07/12/2011
Last updated
07/03/2012
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