Healthcare Provider Details

I. General information

NPI: 1881733202
Provider Name (Legal Business Name): SENIOR MEDICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 POSTIGO LAKEVIEW
WEBSTER NY
14580-9053
US

IV. Provider business mailing address

115 POSTIGO LAKEVIEW
WEBSTER NY
14580-9053
US

V. Phone/Fax

Practice location:
  • Phone: 585-872-2710
  • Fax: 972-236-5360
Mailing address:
  • Phone: 585-872-2710
  • Fax: 972-236-5360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS G POSTIGO
Title or Position: MEMBER
Credential: M.D.
Phone: 585-872-2710