New York State Department of Health, Wadsworth Center
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Trinity Medical WNY PC
PFI: Y805 Secondary Site ID: 0000 Certification Type: WAIVER Director: Matthew G McClure, M.D. Phone: (716) 677-6800 Fax: (716) 677-6804 Address: 310 Sterling Dr - Suite 100, Orchard Park, NY 14127 County: Erie Country: United States Single or Primary Contact: Nicholas Humphrey Contact Phone: (716) 677-6800 CLIA #: 33D2182413
PFI: Y809 Secondary Site ID: 0000 Certification Type: WAIVER Director: Philip D Wilken, M.D. Phone: (845) 707-8400 Fax: (845) 707-8916 Address: 606 Old Rte 17, Monticello, NY 12701 County: Sullivan Country: United States Single or Primary Contact: Ms. Nicole L Rizzitiello Contact Phone: (845) 707-8532 CLIA #: 33D2182591
PFI: Y809 Secondary Site ID: 0001 Certification Type: WAIVER Director: Philip D Wilken, M.D. Phone: 84579414006828 Fax: Address: 195 Lake Luise Marie Rd, Rock Hill, NY 12775 County: Sullivan Country: United States Single or Primary Contact: Ms. Nicole L Rizzitiello Contact Phone: CLIA #: 33D2182591
PFI: Y815 Secondary Site ID: 0000 Certification Type: WAIVER Director: Michael A Manuszewski,RPh Phone: (716) 773-5599 Fax: (716) 773-5665 Address: 1728 Grand Island Blvd, Grand Island, NY 14072 County: Erie Country: United States Single or Primary Contact: Michael Manuszewski Contact Phone: (716) 773-5599 CLIA #: 33D2184418
PFI: Y818 Secondary Site ID: 0000 Certification Type: WAIVER Director: Robert J. Paeglow, M.D. Phone: (518) 621-7748 Fax: (518) 621-7118 Address: 65 Central Ave, Albany, NY 12206 County: Albany Country: United States Single or Primary Contact: Ali Imran Raza Contact Phone: (518) 621-7748 CLIA #: 33D2184421
PFI: Y819 Secondary Site ID: 0000 Certification Type: WAIVER Director: Zeiad A Fakhouri, M.D. Phone: (315) 382-9947 Fax: (847) 368-6651 Address: 1125 Ridge Rd, Webster, NY 14580 County: Monroe Country: United States Single or Primary Contact: Daniel Rodriguez Contact Phone: (847) 282-2589 CLIA #: 33D2184221
PFI: Y822 Secondary Site ID: 0000 Certification Type: WAIVER Director: Chester H Fox, M.D. Phone: (212) 737-8800 Fax: (212) 628-0138 Address: 1631 York Ave, New York, NY 10028 County: New York Country: United States Single or Primary Contact: Ilana Aminov Contact Phone: (212) 737-8800 CLIA #: 33D2184423
PFI: Y823 Secondary Site ID: 0000 Certification Type: WAIVER Director: Chester H Fox, M.D. Phone: (845) 496-8001 Fax: (845) 496-8005 Address: 32 W Main St - Unit 2, Washingtonville, NY 10992 County: Orange Country: United States Single or Primary Contact: Mark Freitas Contact Phone: (845) 496-8001 CLIA #: 33D2184424
PFI: Y830 Secondary Site ID: 0000 Certification Type: WAIVER Director: Chester H Fox, M.D. Phone: (518) 674-3663 Fax: (518) 674-1400 Address: 1636 Burden Lake Rd, Averill Park, NY 12018 County: Rensselaer Country: United States Single or Primary Contact: Miller Young Contact Phone: (518) 674-3663 CLIA #: 33D2183414
PFI: Y831 Secondary Site ID: 0000 Certification Type: WAIVER Director: Thomas J. Madejski, M.D. Phone: (716) 735-3261 Fax: (716) 735-3351 Address: 81 Rochester Rd, Middleport, NY 14105 County: Niagara Country: United States Single or Primary Contact: Stephen L Giroux Contact Phone: (716) 735-3261 CLIA #: 33D2184480
PFI: Y834 Secondary Site ID: 0000 Certification Type: WAIVER Director: Donald W Arthur,RPh Phone: (716) 835-6778 Fax: (716) 362-0985 Address: 935 Brighton Rd, Tonawanda, NY 14150 County: Erie Country: United States Single or Primary Contact: Michael Arthur Contact Phone: (716) 510-6256 CLIA #: 33D2184222