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General NPI Number Information
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NPI Number | 1841211836
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Entity Type | Organization
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Legal Business Name | LAKESIDE ENT & ALLERGY LLC.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 229 PARRISH ST SUITE 250
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1795
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Country | US
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Telephone | 585-394-8800
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Fax | 585-394-5942
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Provider Business Mailing Address
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Address Line | 229 PARRISH ST SUITE 250
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1791
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Country | US
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Telephone | 585-394-8800
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Fax | 585-394-8800
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DANIELLE LAROCCA
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Credential |
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Telephone | 585-394-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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