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LAKESIDE PHYSICIAN GROUP
NPI 1942359989
General Practice in Brockport, NY

Active since January 09, 2007
156 WEST AVE, BROCKPORT, NY 14420(585) 395-6095(585) 395-6084 Get Directions Write a Review

NPPES record last updated: March 25, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lakeside Physician Group NPPES

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

LAKESIDE PHYSICIAN GROUP (NPI 1942359989) is a healthcare organization registered as a general practice in Brockport, New York and active in the NPI registry since January 2007. The organization lists Michelle Kingdollar, Accounts Receivable Manager, as its authorized official.

NPPES Registry Identity

NPI1942359989
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameLAKESIDE MEMORIAL HOSPITAL INC.
Location Address156 WEST AVEBrockport, NY 14420
Mailing Address156 West AveBrockport, NY 14420 · (585) 395-6095 · Fax (585) 395-6084
Phone(585) 395-6095
Fax(585) 395-6084
Organization SubpartNo
Authorized OfficialMichelle KingdollarAccounts Receivable Manager · (585) 395-6095
Enumeration DateJanuary 9, 2007
Last NPPES UpdateMarch 25, 2011
✔ NPI 1942359989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
156 WEST AVE, Brockport, NY 14420
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Other Names 1

Other NameLakeside Physician Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

LAKESIDE IMAGING, LLC
Radiology (Diagnostic Radiology)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (716) 859-2954
DR. TIMOTHY VERNON HAGY M.D.
Emergency Medicine (Emergency Medical Services)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 395-6095
UNIVERSITY OF ROCHESTER
Pharmacy (Community/Retail Pharmacy)
156 WEST AVE, PHARMACY
BROCKPORT, NY 14420
Monroe County (585) 758-7562
ERIK PETERSON D.O.
Emergency Medicine
156 WEST AVE, EMERGENCY DEPARTMENT
BROCKPORT, NY 14420
Monroe County (585) 395-6095
EMMA LEATHAM PA-C
Physician Assistant (Medical)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 758-7557
AMY LORRAINE STACY MS, RD, CDN
Dietitian, Registered
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 395-6095
INTERNAL MEDICINE AT LAKESIDE
Internal Medicine
156 WEST AVE, SUITE 106
BROCKPORT, NY 14420
Monroe County (585) 395-6095
JORDAN BLOCK
Physical Therapist (Orthopedic)
156 WEST AVE
BROCKPORT, NY 14420
Monroe County (585) 275-5321

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 Lakeside Memorial Hospital Inc.'s NPI number?

The NPI number for Lakeside Memorial Hospital Inc. is 1942359989. It was assigned to this organization in the NPPES registry on January 9, 2007. The provider is also known as Lakeside Physician Group.

Where is Lakeside Memorial Hospital Inc. located?

Lakeside Memorial Hospital Inc. is located at 156 West Ave, Brockport, NY 14420. The listed phone number is (585) 395-6095.

What is Lakeside Memorial Hospital Inc.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Lakeside Memorial Hospital Inc. was last updated on March 25, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.