Healthcare Provider Details

I. General information

NPI: 1568417236
Provider Name (Legal Business Name): STEVEN A RICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PORTLAND AVE SUITE 200
ROCHESTER NY
14621-3038
US

IV. Provider business mailing address

1415 PORTLAND AVE SUITE 200
ROCHESTER NY
14621-3038
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-0390
  • Fax:
Mailing address:
  • Phone: 585-922-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number165985
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number165985
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: