Healthcare Provider Details

I. General information

NPI: 1609263185
Provider Name (Legal Business Name): R&B MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COLLEGE PKWY STE 260
BUFFALO NY
14221-6800
US

IV. Provider business mailing address

100 COLLEGE PARKWAY STE 260
WILLIASMVILLE NY
14221
US

V. Phone/Fax

Practice location:
  • Phone: 716-635-0688
  • Fax: 716-204-9574
Mailing address:
  • Phone: 716-635-0688
  • Fax: 716-204-9574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberF307188
License Number StateNY

VIII. Authorized Official

Name: ROSALBA MUCCIARELLA
Title or Position: PARTNER
Credential: MD
Phone: 716-635-0688