Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 137275 | NY |
N | 207P00000X | Emergency Physician | 137275-1 | NY |
N | 207QA0401X | Family Doctor - Addiction Medicine | NY137275 | NY |
N | 208D00000X | General Practice Physician | NY137275 | NY |
NPI | 1396734794 |
---|---|
Provider Name | Richard Chmielewski |
First Address | New Hartford, NY 13413-3200 |
Second Address | New Hartford, NY 13413-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2005 |
Last Update Date | 21/06/2017 |