Doctor Name: | MRS. SALLY ANN RICHARDSON |
NPI Number: | 1093873101 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F304105-1 |
Business Practice Address: | 72 Fulton Ave Suite 300 Hempstead, NY - 115503651 |
Business Phone Number: | 5163852920 |
Business Fax Number: | 5163852293 |
Mailing Address: | 72 Fulton Ave, Suite 300 HEMPSTEAD |
State: | NY |
Postal Code: | 115503651 |
Phone Number: | 5163852920 |
Fax Number: | 5163852293 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 11/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F304105-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |