River Park Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

188335 Issued in NY

Legal business name

RIVER PARK FAMILY MEDICINE, PC

Practice address

15 Hospital Dr
Suite B
Massena, NY 13662-1037

Phone

(315) 764-1447

Fax

(315) 764-1447

NPI assigned

Jan 21, 2010

Organization subpart

No

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

Authorized official

Name

Elizabeth Logalbo, DO

Title

DO/Owner

Phone

(315) 764-1447

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Donna Jaworski, PA

  • Physician Assistant
  • Buffalo, NY
  • NPI 1982764312
  NPD (past)
• Lynne S Ross, MD

  • Family Medicine Physician
  • North Tonawanda, NY
  • NPI 1154388049
  NPD (past)

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1447581079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NIAGARA FALLS BLVD",
            "address_2": "SUITE 208",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202019",
            "telephone_number": "716-692-3302",
            "fax_number": "716-692-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621037",
            "telephone_number": "315-764-1447",
            "fax_number": "315-764-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER PARK FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "LOGALBO",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DO/OWNER",
        "authorized_official_telephone_number": "315-764-1447",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "188335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632048",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle W Ramsdell, CCC/SLP
• Randal J Place
• Kim M Reynolds
• Triston Riley, PA-C
• Rite Aid of New York Inc
• Diane E Roberts
• Roxanne Annette Roberts, FNP
• Nancy Marie Robideau, RN
• Jo Ann Roehm, LPN
• Samantha Sharon Roehm, RN

• Family Medicine Physician in Massena, NY
• Providers in Massena, 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 Jan 21, 2010; 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.