MEDICARE: DR. RICHARD IRVING NETSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	41214	MA
2	2084P0800X	Psychiatry Physician	41214	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487617775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD IRVING NETSKY M.D.

Provider Business Mailing Address
First Line	:	12 BURNLEY RD
Second Line	:
City	:	NORWOOD
State	:	MA
Zip	:	02062-1103
Country	:	US
Telephone Number	:	671-365-2047
Fax Number	:	781-740-0233

Provider Business Practice Location Address
First Line	:	175 DERBY ST STE 7
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-4021
Country	:	US
Telephone Number	:	617-876-4099
Fax Number	:	781-740-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2006
Last Update Date	:	07/11/2022

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