Doctor Name: | DR. GEORGE D RICHARDS |
NPI Number: | 1386916815 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 84260 |
Business Practice Address: | 17 Beach Road Laurel, NY - 11948 |
Business Phone Number: | 6312984269 |
Business Fax Number: | |
Mailing Address: | 1451 Route 25, Po Box 1017 JAMESPORT |
State: | NY |
Postal Code: | 119479700 |
Phone Number: | 6312984269 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 84260 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |