Healthcare Provider Details

I. General information

NPI: 1922018845
Provider Name (Legal Business Name): LOWVILLE MEDICAL ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 DAYAN ST
LOWVILLE NY
13367-1100
US

IV. Provider business mailing address

5402 DAYAN ST
LOWVILLE NY
13367-1100
US

V. Phone/Fax

Practice location:
  • Phone: 315-376-4600
  • Fax: 315-376-5587
Mailing address:
  • Phone: 315-376-4600
  • Fax: 315-376-5587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number013015-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: STEVEN L LYNDAKER
Title or Position: PHYSICIAN PROVIDER PARTNER
Credential: MD
Phone: 315-376-4600