Healthcare Provider Details

I. General information

NPI: 1003058652
Provider Name (Legal Business Name): JOSEPH ANTHONY RINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2009
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 MARGARET ST
PLATTSBURGH NY
12901-1755
US

IV. Provider business mailing address

450 MARGARET ST
PLATTSBURGH NY
12901-1755
US

V. Phone/Fax

Practice location:
  • Phone: 518-566-2020
  • Fax:
Mailing address:
  • Phone: 518-566-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number251599
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: