MEDICARE: DR. ELLEN RICH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	193752	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0409106	OTHER	NY	INDEPENDENT HEALTH
2	00010296201	OTHER	NY	EXCELLUS UNIVERA
3	000524645003	OTHER	NY	HEALTH NOW
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366418345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELLEN RICH MD

Provider Business Mailing Address
First Line	:	3980 SHERIDAN DR
Second Line	:	6TH FLOOR
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-961-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3980 SHERIDAN DR
Second Line	:	6TH FLOOR
City	:	AMHERST
State	:	NY
Zip	:	14226-1727
Country	:	US
Telephone Number	:	716-961-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	11/23/2011

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