Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 198221 | NY |
NPI | 1023126943 |
---|---|
Provider Name | Irene H Richard |
First Address | Rochester, NY 14642 |
Second Address | Rochester, NY 14618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 12/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01613372 | (05) | NY |
G15657 | (02) | NY |