| Organization Name: | LAKESIDE HEALTH SYSTEM |
| NPI Number: | 1790996056 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN A. BAKER (REGISTERED DIETITIAN) |
| Mailing Address: | 1173 Peck Rd Hilton |
| State: | NY US |
| Postal Code: | 144689347 |
| Phone Number: | 5853664082 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 838482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |