Organization
LAKESIDE HEALTH SYSTEM MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STAPLETON (CEO)
(585) 395-6095
Entity
Organization
Contact information
Practice address
156 WEST AVE, BROCKPORT, NY 14420-1229
(716) 637-3131
Mailing address
333 METRO PARK, F203, ROCHESTER, NY 14623-2638
(585) 697-3433
(585) 697-7558
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
12/31/2009
Last updated
01/05/2010
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