Healthcare Provider Details

I. General information

NPI: 1265884209
Provider Name (Legal Business Name): RICHARD A FICHMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 ALBANY AVE
HARTFORD CT
06112-2113
US

IV. Provider business mailing address

178 HARTFORD RD
MANCHESTER CT
06040-5986
US

V. Phone/Fax

Practice location:
  • Phone: 860-560-9563
  • Fax:
Mailing address:
  • Phone: 860-649-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: RICHARD A FICHMAN
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 860-649-9973