Provider Demographics
NPI:1518198670
Name:RIGHTMIER, CRAIG MICHAEL (PA)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:MICHAEL
Last Name:RIGHTMIER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 LONG POND RD
Mailing Address - Street 2:EMERGENCY CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4122
Mailing Address - Country:US
Mailing Address - Phone:585-723-7070
Mailing Address - Fax:585-723-7083
Practice Address - Street 1:1555 LONG POND RD
Practice Address - Street 2:EMERGENCY CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4122
Practice Address - Country:US
Practice Address - Phone:585-723-7070
Practice Address - Fax:585-723-7083
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013395363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03140961Medicaid
NYJ400042087/GP BA0017Medicare PIN
NY03140961Medicaid