Wegman Family (Brockport) LLC II

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

370-S-849 Issued in NY

Legal business name

WEGMAN FAMILY (BROCKPORT) LLC II

Practice address

90 West Ave
Brockport, NY 14420-1306

Phone

(585) 637-3140

Fax

(585) 637-3145

NPI assigned

Dec 1, 2009

Organization subpart

No

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

Authorized official

Name

Noelle Diaz Bickel

Title

Licensing Specialist

Phone

(206) 298-2909

Specialties & licenses 2

Addresses

Other names 1

• Landing at Brockport Doing business as

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1326376468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WEST AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201306",
            "telephone_number": "585-637-3140",
            "fax_number": "585-637-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEGMAN FAMILY (BROCKPORT) LLC II",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NY",
            "license": "370-S-849",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NY",
            "license": "370-S-849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landing at Brockport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores, East, LP
• Walgreen Co
• Kimberly Sue Walitzer, PHD
• Krystal A Wallis, PHARM D
• Carla Watson, LPN
• Wegmans Food Markets, Inc.
• Weinstein Dental Group, PLLC
• Sol H Weinstein
• Stephen Weinstein
• Jason Wentworth, ATC, CSCS

• Assisted Living Facility in Brockport, NY
• Providers in Brockport, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.