GREAT LAKES LOCUMS LLC (NPI# 1174058549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174058549 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES LOCUMS LLC |
| Practice Address |
2950 Elmwood Ave Kenmore NY 14217-1304 |
| Mailing Address |
13 Viscount Dr Williamsville NY 14221-1766 |
| Practice Telephone | 7164476100 |
| Mailing Telephone | 7168632454 |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |
| Authorized Official Name | MIAN MAJEED (OWNER) |
| Authorized Official Telephone | 7168632454 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
2950 ELMWOOD AVE |
| City | KENMORE |
| State | NY |
| Zip Code | 14217-1304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734066 | Victoria Paulsen | Anesthesiology | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-06-16 |
| 1659909752 | Kenmore Mercy Hospital | Internal Medicine | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2020-04-01 |
| 1962048793 | David Michael Armstrong | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-11-27 |
| 1790332443 | Theresa Lynn Jackson | Dietitian, Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2019-08-19 |
| 1619424884 | Buffalo Niagara Hospitalist LLC | General Acute Care Hospital | 2950 Elmwood Ave, Kenmore, NY 14217 | 2016-09-06 |
| 1629525167 | Caitlin Elizabeth Ortiz | Nurse Practitioner | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2016-09-01 |
| 1255714762 | Krystal R Burns | Nurse Anesthetist, Certified Registered | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-07-01 |
| 1033591342 | Robert E Baker IIi | Physician Assistant | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-06-23 |
| 1295114601 | Jeffrey Olek | Pharmacist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-05-19 |
| 1225416274 | Kristen Kelsey | Pharmacist | 2950 Elmwood Ave, Kenmore, NY 14217-1304 | 2015-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585201 | Emma Rae Rooney | Student in an Organized Health Care Education/Training Program | 2900 Delaware Ave., Kenmore, NY 14217 | 2019-12-11 |
| 1558801530 | Elizabeth Fazio | Local Education Agency (LEA) | 3767 Delaware Ava, Kenmore, NY 14217 | 2017-02-24 |
| 1477940393 | Laura Sabia | Case Manager/Care Coordinator | 2900 Deleware Avenue, Kenmore, NY 14217 | 2015-04-17 |
| 1770994881 | Kenmore Family Medicine | Family Medicine | 2914 Elmwood Avenue, Kenmore, NY 14217 | 2014-05-12 |
| 1144576265 | Elizabeth Anne Leiser | Nurse Practitioner | 274 W Girard Blvd, Kenmore, NY 14217 | 2012-07-26 |
| 1730442385 | Christopher Landeo | Case Manager/Care Coordinator | 2900 Delaware Avenue, Kenmore, NY 14217 | 2012-06-19 |
| 1013291095 | Sharon Karnyski | Physical Therapist | 2900 Delaware Avenu, Kenmore, NY 14217 | 2011-10-07 |
| 1164706784 | Joanne Karen Cascio | Registered Nurse | 3756 Delaware Avenue, Kenmore, NY 14217 | 2011-09-30 |
| 1467742692 | Nicole Anne Perrotta | Occupational Therapy Assistant | 3767 Delaware Avenue, Kenmore, NY 14217 | 2011-04-08 |
| 1538466511 | Diane J. Sutter, M.d., LLC | Obstetrics & Gynecology | 3800 Delaware Avenue, Suite 102, Kenmore, NY 14217 | 2011-02-28 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417126798 | Rajwinder Singh Dhillon | Internal Medicine | 30 Louvaine Drive, Kenmore, NY 14223 | 2008-02-21 |
| 1811183742 | Anthony F. Perna, M.d. | Internal Medicine | 41 Delaware Rd, Kenmore, NY 14217-2742 | 2007-09-25 |
| 1639256548 | Irshad Ali | Internal Medicine | 357 Englewood Ave, Kenmore, NY 14223-2807 | 2006-11-01 |
| 1023101607 | Zulkharnain Medical Services, PC | Internal Medicine | Kenmore Mercy Hospital, 2885 Kenmore Ave, Kenmore, NY 14217 | 2006-10-02 |
| 1245270388 | Susan Baldassari | Internal Medicine | 3673 Delaware Ave, Kenmore, NY 14217-1113 | 2006-06-07 |
| 1134516735 | Susan Baldassari Md | Internal Medicine | 3673 Delaware Ave, Kenmore, NY 14217-1113 | 2015-04-21 |
| 1912329368 | Tarik Elibol, Md | Internal Medicine | 2949 Elmwood Ave, Ste 202, Kenmore, NY 14217-1356 | 2014-01-19 |
| 1215367289 | Irshad Ali, Md | Internal Medicine | 357 Englewood Ave, Kenmore, NY 14223-2807 | 2013-11-12 |
| 1841639168 | Susan Eluard | Internal Medicine | 3800 Delaware Ave, Kenmore, NY 14217-1094 | 2013-06-19 |
| 1366791998 | Alan M Antfleck Physician Pllc | Internal Medicine | 3800 Delaware Ave, Suite 102, Kenmore, NY 14217-1094 | 2012-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.