Organization
LAKESIDE MEDICAL PRACTICE PLLC
Active
Other names
Lakeside Medical Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA J SNOW PA-C (CEO)
(716) 526-1183
Entity
Organization
Contact information
Practice address
133 FAIRMOUNT AVENUE, LAKEWOOD, NY 14750-1948
(716) 526-1183
(716) 526-1165
Mailing address
133 E. FAIRMOUNT AVENUE, LAKEWOOD, NY 14750-1948
(716) 526-1183
(716) 526-1165
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
08/07/2025
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