Healthcare Provider Details

I. General information

NPI: 1689647695
Provider Name (Legal Business Name): RAHUL LAROIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 WILLOW POND WAY SUITE 200
PENFIELD NY
14526-2638
US

IV. Provider business mailing address

43 WILLOW POND WAY SUITE 200
PENFIELD NY
14526-2638
US

V. Phone/Fax

Practice location:
  • Phone: 585-377-5420
  • Fax: 585-377-3690
Mailing address:
  • Phone: 585-377-5420
  • Fax: 585-377-3690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number203291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: