Organization
LAKESIDE MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TROY SASSE D.O. (PHYSICIAN)
(716) 549-4999
Entity
Organization
Contact information
Practice address
8746 ERIE RD, SUITE A, ANGOLA, NY 14006-9620
(716) 549-4999
(716) 549-4998
Mailing address
8746 ERIE RD, SUITE A, ANGOLA, NY 14006-9620
(716) 549-4999
(716) 549-4998
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
266476-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4529111 TYPE 2
—
NY
Enumeration date
09/28/2015
Last updated
09/15/2016
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