Healthcare Provider Details

I. General information

NPI: 1427360122
Provider Name (Legal Business Name): RITCHIE DEVASSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2010
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 LONG POND RD
ROCHESTER NY
14626-4168
US

IV. Provider business mailing address

1565 LONG POND RD
ROCHESTER NY
14626-4168
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7723
  • Fax:
Mailing address:
  • Phone: 585-723-7723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number316312
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number316312
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: