Individual
BRIAN C RIESENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(585) 275-9555
Mailing address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(585) 275-9555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013768
NY
363A00000X
Physician Assistant
13768
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03574783
—
NY
Enumeration date
01/10/2010
Last updated
07/06/2023
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