Doctor Name: | STACY ANN RICHEY |
NPI Number: | 1255737136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 25MA07151700 |
Business Practice Address: | 1401 New Road Linwood, NJ - 08221 |
Business Phone Number: | 6099275885 |
Business Fax Number: | 6099275565 |
Mailing Address: | P.o. Box 107, LINWOOD |
State: | NJ |
Postal Code: | 08221 |
Phone Number: | 6099275885 |
Fax Number: | 6099275565 |
NPI Enumeration Date: | 11/05/2014 |
NPI Last Update Date: | 11/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 25MA07151700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |