Organization
LAKESHORE ORTHOPEDIC GROUP P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CONANT (PRACTICE ADMINISTRATOR)
(716) 366-7150
Entity
Organization
Contact information
Practice address
849 RTS 5 & 20, SUITE 1, IRVING, NY 14081
(716) 934-3493
Mailing address
849 RTS 5 & 20, SUITE 1, IRVING, NY 14081
(716) 934-3493
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/21/2009
Last updated
01/25/2011
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