Provider Demographics
NPI:1609111251
Name:OATKA FAMILY MEDICINE P.C.
Entity Type:Organization
Organization Name:OATKA FAMILY MEDICINE P.C.
Other - Org Name:OATKA FAMILY MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-201-7055
Mailing Address - Street 1:5762 E MAIN STREET RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-9621
Mailing Address - Country:US
Mailing Address - Phone:585-201-7055
Mailing Address - Fax:585-219-6140
Practice Address - Street 1:5762 E MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-9621
Practice Address - Country:US
Practice Address - Phone:585-201-7055
Practice Address - Fax:585-219-6140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100084443OtherMEDICARE PTAN