Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 142859 | NY |
Y | 111NI0900X | Internist | 142859 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 188671 | NY |
N | 208000000X | Pediatrician | 049755 | NY |
NPI | 1609978329 |
---|---|
Provider Name | Mr. Michael Lloyd Richter |
First Address | Rego Park, NY 11374 |
Second Address | Rego Park, NY 11374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 17/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F31927 | (02) |