Organization
CROOKED LAKE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WALK-REINARD MD (OWNER)
(315) 536-0086
Entity
Organization
Contact information
Practice address
1930 PRE EMPTION RD, PENN YAN, NY 14527-9641
(315) 536-0086
(315) 536-4107
Mailing address
PO BOX 1077, GENEVA, NY 14456-8077
(315) 536-0086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
209529
NY
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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