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

Lakeside Medical Practice PLLC

Organization Clinic/Center · NPI 1518720291

Lakeside Medical Practice PLLC is a Clinic/Center in Lakewood, New York. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

133 Fairmount Ave
Lakewood, NY 14750-1948
Phone: (716) 526-1183
Fax: (716) 526-1165
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1518720291
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alicia Snow — Ceo · (716) 526-1183
Other names Lakeside Medical Practice
NPI enumeratedFebruary 5, 2024
Last updated in NPPESAugust 7, 2025
Certification dateFebruary 5, 2024
Mailing address133 E. Fairmount Avenue, Lakewood, NY 14750-1948