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LAKESHORE FAMILY MEDICINE DERBY
NPI 1801211826
Non-Pharmacy Dispensing Site in Derby, NY

Active since February 27, 2014
7060 ERIE RD, SUITE 100, DERBY, NY 14047(716) 947-0408 Get Directions Write a Review

NPPES record last updated: February 27, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakeshore Family Medicine Derby NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESHORE FAMILY MEDICINE DERBY (NPI 1801211826) is a healthcare organization registered as a non-pharmacy dispensing site in Derby, New York and active in the NPI registry since February 2014. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1801211826
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameLAKESHORE FAMILY MEDICINE ASSOCIATES PC
Location Address7060 ERIE RD, SUITE 100Derby, NY 14047-9430
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(716) 947-0408
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateFebruary 27, 2014
✔ NPI 1801211826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in NY · 233142
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
7060 ERIE RD, Derby, NY 14047
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Other Names 1

Doing Business AsLakeshore Family Medicine Derby

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH BETH CELIA FNP-BC
Family Medicine
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0408
DENT NEUROLOGIC GROUP, LLP
Psychiatry & Neurology (Neurology)
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 250-2000
LAKESHORE FAMILY MEDICINE ASSOC PC
Family Medicine
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0408
ANGEL M SZKUTAK P.A.
Physician Assistant
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0408
ERIC DIBBEN PA
Physician Assistant
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0408
JENNIFER FOLEY
Massage Therapist
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0320
DEBBIE OPOKU
Nurse Practitioner (Family)
7060 ERIE RD
DERBY, NY 14047
Erie County (716) 947-0408
DONALD JORDAN CONRAD D.C.
Chiropractor
7060 ERIE RD, SUITE 300
DERBY, NY 14047
Erie County (716) 947-0139

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeshore Family Medicine Associates PC's NPI number?

The NPI number for Lakeshore Family Medicine Associates PC is 1801211826. It was assigned to this organization in the NPPES registry on February 27, 2014. The provider is doing business as Lakeshore Family Medicine Derby.

Where is Lakeshore Family Medicine Associates PC located?

Lakeshore Family Medicine Associates PC is located at 7060 Erie Rd Suite 100, Derby, NY 14047. The listed phone number is (716) 947-0408.

What is Lakeshore Family Medicine Associates PC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Lakeshore Family Medicine Associates PC was last updated on February 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.