Healthcare Provider Details

I. General information

NPI: 1023464203
Provider Name (Legal Business Name): SCOTT JOSEPH BIEHL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 RIDGEWAY AVE
ROCHESTER NY
14626-4114
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-3000
  • Fax: 585-723-6877
Mailing address:
  • Phone: 585-723-3000
  • Fax: 585-723-6877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number291177
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: