Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 30 304687 | NY |
NPI | 1023284031 |
---|---|
Provider Name | Mrs. Irene Richman |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2008 |
Last Update Date | 30/04/2008 |