Healthcare Provider Details

I. General information

NPI: 1295939353
Provider Name (Legal Business Name): TRI-COUNTY FAMILY MEDICINE PROGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 N STATE ST
NUNDA NY
14517-9785
US

IV. Provider business mailing address

10869 STATE ROUTE 36
DANSVILLE NY
14437-9444
US

V. Phone/Fax

Practice location:
  • Phone: 585-468-2528
  • Fax: 585-468-5424
Mailing address:
  • Phone: 585-335-3100
  • Fax: 585-335-8695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN A STONE
Title or Position: CEO
Credential:
Phone: 585-335-3416