Healthcare Provider Details

I. General information

NPI: 1467911446
Provider Name (Legal Business Name): NICHOLAS RUBEN KUREK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVENUE
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX679
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-4290
  • Fax: 585-473-1573
Mailing address:
  • Phone: 585-275-4290
  • Fax: 585-473-1573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.144091
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.144091
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: