Lakeshore Surgical Practice, PC

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

239232 Issued in NY

Legal business name

LAKESHORE SURGICAL PRACTICE, PC

Practice address

30 Erie Canal Dr
Suite E
Rochester, NY 14626-4604

Phone

(585) 637-2930

Fax

(585) 637-2930

NPI assigned

Sep 9, 2013

Last updated

Sep 9, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Richard J King, MD

Title

Physician

Phone

(585) 637-2930

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1578998696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK AVE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201913",
            "telephone_number": "585-637-2930",
            "fax_number": "585-507-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ERIE CANAL DR",
            "address_2": "SUITE E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264604",
            "telephone_number": "585-637-2930",
            "fax_number": "585-637-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE SURGICAL PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "585-637-2930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "239232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02752716",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Johanna Lais, MS, CCC-SLP/L
• Maryann Lake, LPN
• Samana B. Lake, P.T.
• Lakeshore Endodontics PC
• Lakeshore Physical Therapy
• Rezarta Lako, PHARMD
• Noam Laks
• Tejaswini Lakshmikeshava, MBBS
• Sowmya Lakshminarayanan, MD
• Emily Lalka

• Surgical Critical Care Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Surgical Critical Care Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.