Healthcare Provider Details

I. General information

NPI: 1710992151
Provider Name (Legal Business Name): RICHARD S AGUIRRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5989 BIG TREE RD SUITE A
LAKEVILLE NY
14480-9719
US

IV. Provider business mailing address

5989 BIG TREE RD STE A
LAKEVILLE NY
14480-9719
US

V. Phone/Fax

Practice location:
  • Phone: 585-346-4460
  • Fax: 585-346-4463
Mailing address:
  • Phone: 585-346-4460
  • Fax: 585-346-4463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE MILLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 585-991-3933