National Provider Identifier

Brockport Vine Medical PC

Brockport Vine Medical 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) 208-8668.

NPI 1871144543Brockport, NYInternal Medicine Physician

Source: public NPPES record, last updated January 03, 2020. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1871144543
Provider Type
Organization
Primary Specialty
Internal Medicine Physician
Enumeration Date
September 24, 2019
Last Updated
January 03, 2020

Practice Location

  • 122 West Ave Ste 6
  • Brockport, NY 14420-1225

Phone: (585) 208-8668

Mailing Address

  • 67 Sarah Cir
  • Spencerport, NY 14559-9592

Authorized Official

Name
Dr. Alex Fahoury
Title
Owner
Credentials
MD
Phone
(585) 208-8668

Specialties

  • Internal Medicine Physician (207R00000X)

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Organization Overview

Brockport Vine Medical P.C., operating as Brockport Vine Medical in Brockport, New York, is an internal medicine and primary care practice focused on general adult health and chronic condition management. The practice says it manages conditions such as diabetes, heart disease, high blood pressure, COPD, asthma, obesity, chronic pain, and women’s health needs, while aiming to reduce unnecessary switching among specialists or hospitals. Its physician profile notes that Dr. Alex Fahoury trained at Penn State University’s Hershey campus and has practiced internal medicine for more than 20 years.

Full Record
NPI
1871144543
Entity Type
Organization
Organization Name
Brockport Vine Medical PC
Mailing Street Address
67 Sarah Cir
Mailing City
Spencerport
Mailing State
NY
Mailing ZIP Code
14559-9592
Mailing Country
US
Mailing Phone
(585) 208-8668
Mailing Fax
(585) 617-4219
Practice Street Address
122 West Ave Ste 6
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1225
Practice Country
US
Practice Phone
(585) 208-8668
Enumeration Date
September 24, 2019
Last Updated
January 03, 2020
Authorized Official Last Name
Fahoury
Authorized Official First Name
Alex
Authorized Official Title
Owner
Authorized Official Phone
(585) 208-8668
Organization Subpart
No
Authorized Official Name Prefix Text
Dr.
Authorized Official Credential Text
MD
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
January 03, 2020
Taxonomies
Internal Medicine Physician (207R00000X)