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General NPI Number Information
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NPI Number | 1689724262
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Entity Type | Organization
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Legal Business Name | ORLEANS MEDICAL PC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11075 W CENTER STREET EXT
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City | MEDINA
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State | NY
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Zip | 14103-9557
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Country | US
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Telephone | 585-798-1053
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Fax | 585-798-5639
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Provider Business Mailing Address
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Address Line | 11075 W CENTER STREET EXT
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City | MEDINA
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State | NY
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Zip | 14103-9557
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Country | US
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Telephone | 585-798-1053
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Fax | 585-798-5639
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JILL E KLOTZBACH
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Credential | MSN, NP
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Telephone | 585-798-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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