Ontario Lakeside Medical Associates

NPI #1184645368 in Oswego, New York

Provider Information

NPI Number: 1184645368
Entity Type: Organization
Organization Name: Ontario Lakeside Medical Associates
Primary Specialty: Internal Medicine
Enumeration Date: Jul 22, 2006
Last Updated: Jul 10, 2018

Practice Location

Address: 90 W UTICA ST
City: Oswego
State: New York
ZIP Code: 13126
Phone: (315) 342-8552

Authorized Official

Name: DR. CARLOS O DATOR, MD
Title: PHYSICIAN
Phone: (315) 342-8552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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