MEDICARE: LUIS G POSTIGO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	240594	NY
2	207R00000X	Internal Medicine Physician	240594	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629071287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS G POSTIGO M.D.

Provider Business Mailing Address
First Line	:	115 POSTIGO LAKEVIEW
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9053
Country	:	US
Telephone Number	:	585-872-2710
Fax Number	:	972-236-5360

Provider Business Practice Location Address
First Line	:	115 POSTIGO LAKEVIEW
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9053
Country	:	US
Telephone Number	:	585-872-2710
Fax Number	:	972-236-5360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/29/2023

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