Lake Plastic and Hand Surgery

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

096119 Issued in OH

Legal business name

LAKE PLASTIC AND HAND SURGERY

Practice address

6532 Anthony Dr
Victor, NY 14564-1403

Phone

(407) 453-1036

NPI assigned

Mar 13, 2013

Organization subpart

No

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

Authorized official

Name

David Graham, MD

Title

Owner/Physician

Phone

(407) 453-1036

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1427399658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 HOUNZ LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231246",
            "telephone_number": "407-453-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6532 ANTHONY DR",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641403",
            "telephone_number": "407-453-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PLASTIC AND HAND SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "407-453-1036",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "096119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karianne Kuchman
• Kulp Physical Therapy
• Douglas Lloyd Kulp, PT
• Brittany E Labore, MS.ED
• Emily Lacosta
• Lakeside Foot & Ankle LLC
• Lakeside Podiatry, PLLC
• Liza Lamberton
• Constantine John Lambropoulos
• Meghan Lang

• Plastic Surgery Physician in Victor, NY
• Providers in Victor, NY by specialty
• Plastic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.