National Provider Identifier

Brockport Internal Medicine, PC

Brockport Internal Medicine, PC is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Brockport, NY and a listed phone number of (585) 637-2161.

NPI 1144434408Brockport, NYInternal Medicine Physician

Source: public NPPES record, last updated August 22, 2020. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1144434408
Provider Type
Organization
Primary Specialty
Internal Medicine Physician
Enumeration Date
May 09, 2007
Last Updated
August 22, 2020

Practice Location

  • 34 West Ave
  • Brockport, NY 14420-1304

Phone: (585) 637-2161

Authorized Official

Name
Pankaj Garg
Title
President
Credentials
M.D.
Phone
(585) 637-2161

Specialties

  • Internal Medicine Physician (207R00000X)

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Full Record
NPI
1144434408
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Brockport Internal Medicine, PC
Mailing Street Address
34 West Ave
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1304
Mailing Country
US
Mailing Fax
(585) 637-5819
Practice Street Address
34 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1304
Practice Country
US
Practice Phone
(585) 637-2161
Practice Fax
(585) 637-5819
Enumeration Date
May 09, 2007
Last Updated
August 22, 2020
Authorized Official Last Name
Garg
Authorized Official First Name
Pankaj
Authorized Official Title
President
Authorized Official Phone
(585) 637-2161
Organization Subpart
No
Authorized Official Credential Text
M.D.
Taxonomy Group 1
193400000X Single Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Internal Medicine Physician (207R00000X)