=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629244041
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIDGEPLEX INTERNAL MEDICINE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2008
-----------------------------------------------------
Last Update Date | 05/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1742 E RIDGE RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14622-2157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-266-0736
-----------------------------------------------------
Fax | 585-266-1612
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1742 E RIDGE RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14622-2157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-266-0736
-----------------------------------------------------
Fax | 585-266-1612
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. LINDA M RICE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 585-266-0736
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 145652
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------