Lakeside Memorial Hospital Inc.

NPI #1740504141 in Brockport, New York

Provider Information

NPI Number: 1740504141
Entity Type: Organization
Organization Name: Lakeside Memorial Hospital Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: LAKESIDE MEMORIAL HOSPITAL INC.
Primary Specialty: Specialist
Enumeration Date: Mar 15, 2010
Last Updated: Jul 13, 2010

Practice Location

Address: 156 WEST AVE
City: Brockport
State: New York
ZIP Code: 14420-1229
Phone: (585) 395-6095

Authorized Official

Name: MS. STACEY SSHARE, MD
Title: BILLER
Phone: (585) 395-6095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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