| Robert W Richardson Md Llc | |
|
181 Franklin Ave Suite 202 Nutley NJ 07110-3820 | |
| (973) 667-4568 | |
| (973) 667-4589 |
| Full Name | Robert W Richardson Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 181 Franklin Ave, Nutley, New Jersey |
| Authorized Official Name and Position | Robert W Richardson (PRESIDENT) |
| Authorized Official Contact | 9736674568 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert W Richardson Md Llc 181 Franklin Ave Suite 202 Nutley NJ 07110-3820 Ph: (973) 667-4568 | Robert W Richardson Md Llc 181 Franklin Ave Suite 202 Nutley NJ 07110-3820 Ph: (973) 667-4568 |
| NPI Number | 1699102277 |
|---|---|
| Provider Enumeration Date | 09/27/2013 |
| Last Update Date | 09/27/2013 |
| Medicare PECOS PAC ID | 3274769963 |
|---|---|
| Medicare Enrollment ID | O20131203000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699102277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA03545600 (New Jersey) | Primary |
| Provider Name | Robert W Richardson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033167978 PECOS PAC ID: 1254236854 Enrollment ID: I20060117000193 |
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