Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD0321158E | PA |
NPI | 1043250202 |
---|---|
Provider Name | Dr. Richard D Shusterman |
First Address | Yardley, PA 19067-5569 |
Second Address | Yardley, PA 19067-5569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 06/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010367320003 | (05) | PA |
290010338 | RAILROAD MEDICARE (01) | |
B34589 | (02) |