Canales, Luis Ivan

Canales, Luis Ivan is an individual health care provider with primary practice located at 181 Maple Street Suite C, Massena NY 13662. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Canales, Luis Ivan can be contacted via phone (315) 769-1667.

Contact Information

Primary practice address
181 Maple Street Suite C Massena NY 13662
Phone: (315) 769-1667
Fax: (315) 769-6430
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207RA0000X 208001 New York
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 208001 New York

Profile Details

NPI number 1518969260
LBN Legal business name Canales, Luis Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Jul 10th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518969260 NPPES
New York MEDICAID 01794976

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