Healthcare Provider Details

I. General information

NPI: 1053009290
Provider Name (Legal Business Name): BRIAN R UNRUH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE # 14642
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

111 CLARA BARTON ST
DANSVILLE NY
14437-9503
US

V. Phone/Fax

Practice location:
  • Phone: 585-756-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number343665
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: