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

Physicians Practice of Eastern Niagara PC

Organization Surgery Physician · NPI 1053733915

Physicians Practice of Eastern Niagara PC is a Surgery Physician in Lockport, New York. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
3
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

15 Elizabeth Dr
Lockport, NY 14094-5226
Phone: (716) 692-3302
Fax: (716) 213-0935
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Surgical Critical Care Physician Taxonomy 2086S0102X
Trauma Surgery Physician Taxonomy 2086S0127X

Record details

NPI number1053733915
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Ickowski — Cfo · (716) 514-5501
NPI enumeratedJanuary 13, 2014
Last updated in NPPESJanuary 13, 2014
Mailing address908 Niagara Falls Blvd, Suite 208, North Tonawanda, NY 14120-2019

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