Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastern Niagara Medical Group

Organization Family Medicine Physician · NPI 1346796398

Eastern Niagara Medical Group is a Family Medicine Physician in Lockport, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
Specialties on file
3

Practice location Address checks out

53 Elizabeth Dr
Lockport, NY 14094-5226
Phone: (716) 514-5501
Fax: (716) 514-5549
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 3101000H (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 3101000H (NY)
Gastroenterology Physician Taxonomy 207RG0100X · Licence 3101000H (NY)

Record details

NPI number1346796398
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEastern Niagara Hospital, Inc
Authorized official Michael Ickowski — Cfo · (716) 514-5501
NPI enumeratedAugust 30, 2016
Last updated in NPPESSeptember 1, 2016
Mailing address521 East Ave, Lockport, NY 14094-3201

Other providers in Lockport