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

Lakeside Memorial Hospital Inc

Organization General Practice Physician · NPI 1942359989

Lakeside Memorial Hospital Inc is a General Practice Physician in Brockport, New York. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

156 W Ave
Brockport, NY 14420
Phone: (585) 395-6095
Fax: (585) 395-6084
Show map & directions

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

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1942359989
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Kingdollar — Accounts Receivable Manager · (585) 395-6095
Other names Lakeside Physician Group
NPI enumeratedJanuary 9, 2007
Last updated in NPPESMarch 25, 2011
Mailing address156 West Ave, Brockport, NY 14420