Provider Demographics
NPI:1881733202
Name:SENIOR MEDICAL CARE PLLC
Entity type:Organization
Organization Name:SENIOR MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:POSTIGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-872-2710
Mailing Address - Street 1:115 POSTIGO LAKEVIEW
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9053
Mailing Address - Country:US
Mailing Address - Phone:585-872-2710
Mailing Address - Fax:972-236-5360
Practice Address - Street 1:115 POSTIGO LAKEVIEW
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9053
Practice Address - Country:US
Practice Address - Phone:585-872-2710
Practice Address - Fax:972-236-5360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02918541Medicaid