MEDICARE: DR. ANDREA RICHMAN DMD

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	122300000X	Dentist	13905	MA

General Provider Information

NPI Number	:	1861483133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA RICHMAN DMD

Provider Business Mailing Address
First Line	:	PO BOX 576
Second Line	:	18 WESTFORD ROAD
City	:	CARLISLE
State	:	MA
Zip	:	01741-0576
Country	:	US
Telephone Number	:	978-369-7967
Fax Number	:	978-369-1086

Provider Business Practice Location Address
First Line	:	18 WESTFORD ST
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1506
Country	:	US
Telephone Number	:	978-369-7967
Fax Number	:	978-369-1086

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

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	07/08/2007

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