Lakeside Medical Practice Pllc

NPI #1518720291 in Lakewood, New York

Provider Information

NPI Number: 1518720291
Entity Type: Organization
Organization Name: Lakeside Medical Practice Pllc
Primary Specialty: Clinic/Center
Enumeration Date: Feb 5, 2024
Last Updated: Aug 7, 2025

Practice Location

Address: 133 FAIRMOUNT AVENUE
City: Lakewood
State: New York
ZIP Code: 14750-1948
Phone: (716) 526-1183

Authorized Official

Name: ALICIA J SNOW, PA-C
Title: CEO
Phone: (716) 526-1183

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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