Provider Demographics
NPI:1528156841
Name:CROSS KEYS INTERNAL MEDICINE,LLP
Entity type:Organization
Organization Name:CROSS KEYS INTERNAL MEDICINE,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-223-4620
Mailing Address - Street 1:420 CROSS KEYS OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 CROSS KEYS OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3506
Practice Address - Country:US
Practice Address - Phone:585-223-4620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROSS KEYS INTERNAL MEDICINE.LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-11
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02265736Medicaid
NY02265736Medicaid