Healthcare Provider Details

I. General information

NPI: 1679917348
Provider Name (Legal Business Name): MR. ALAN STEVEN RIFKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TOWPATH TRL
ROCHESTER NY
14624-4552
US

IV. Provider business mailing address

160 GREECE RIDGE CENTER DR
GREECE NY
14626-2815
US

V. Phone/Fax

Practice location:
  • Phone: 585-478-3993
  • Fax:
Mailing address:
  • Phone: 585-227-6771
  • Fax: 585-227-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number007911
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: