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Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

Eastern Niagara Medical Group

Family Medicine Physician in Lockport, NY · enumerated 2016 · authorized official Michael Ickowski, Cfo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1346796398

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Registry record

Entity type Organization (Type 2)
Legal business name Eastern Niagara Medical Group
Parent organization Eastern Niagara Hospital, Inc
Practice address 53 Elizabeth Dr, Lockport, NY, 14094
Phone (716) 514-5501
Fax (716) 514-5549
Enumeration date Aug 30, 2016
Last updated in NPPES Sep 1, 2016

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 3101000H (NY) Primary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians · License 3101000H (NY) Secondary
207RG0100X Gastroenterology Physician Allopathic & Osteopathic Physicians · License 3101000H (NY) Secondary

Authorized official

Name Michael Ickowski
Title Cfo
Phone (716) 514-5501

Other identifiers

Identifier Type State Issuer
00354389 Medicaid NY -
3101000H Other NY LICENSE NUMBER - OPERATING CERTIFICATE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Eastern Niagara Medical Group located?
The practice location on file with NPPES is in Lockport, NY.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2016-09-01. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2016-09-01.