Richard F Endres, M.D.

Individual provider Active NPI Pediatrics Physician · Sodus, NY

NPI 1295746071 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295746071
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
126286 (NY)
Practice address
6692 Middle Rd
Sodus, NY 14551-9602
Phone
(315) 483-3214
Fax
(315) 483-3248
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
126286NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 126286 NY Yes

Addresses

Primary practice location

6692 Middle Rd
Sodus, NY 14551-9602

Mailing address

6692 Middle Rd
Sodus, NY 14551-9602
Phone (315) 483-3214

Other identifiers

IdentifierTypeStateIssuer
00450679MedicaidNY

Other providers in Sodus, NY

All providers in Sodus, NY · Pediatrics Physician in New York

Sources for this page

Verify at the official NPI Registry.