Doctor Hany G Nissiem Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

227675 Issued in NY

Legal business name

DOCTOR HANY G NISSIEM FAMILY MEDICINE PLLC

Practice address

6565 Fourth Section Rd
Suite 300
Brockport, NY 14420-2414

Phone

(585) 395-0620

Fax

(585) 395-0622

NPI assigned

May 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Hany Nissiem, M.D.NPI 1295782399

Title

Owner

Phone

(585) 395-0620

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hany G Nissiem, M.D

  • Family Medicine Physician
  • Brockport, NY
  • NPI 1295782399
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1184670283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 FOUTH SECTION RD",
            "address_2": "SUITE 300",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202416",
            "telephone_number": "585-395-0620",
            "fax_number": "585-395-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 FOURTH SECTION RD",
            "address_2": "SUITE 300",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202414",
            "telephone_number": "585-395-0620",
            "fax_number": "585-395-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR HANY G NISSIEM FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "NISSIEM",
        "authorized_official_first_name": "HANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-395-0620",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "227675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Devalder, RDH
• Athena Diamandis, DMD
• Kristy Genung Dibelka, LMT
• Sarah B Dick, LPN
• Alyssa A Dimartino
• Barbara A Dodson, LPN
• Kathleen A Donahue, PSYD
• Marissa Lee Douglas, LMHC
• Karissa Anne Dube, PHARMD
• Briana Dunton

• Family Medicine Physician in Brockport, NY
• Providers in Brockport, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.