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.
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)