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

Evergreen Family Medicine, PC

Organization Family Medicine Physician · NPI 1528164936

Evergreen Family Medicine, PC is a Family Medicine Physician in Brockport, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4079 Lake Rd N
Brockport, NY 14420-1517
Phone: (585) 637-0151
Fax: (585) 637-0562
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (NY)

Record details

NPI number1528164936
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Newman — President · (585) 637-0151
NPI enumeratedSeptember 15, 2006
Last updated in NPPESAugust 22, 2020
Mailing address4079 Lake Rd N, Brockport, NY 14420-1517

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