Healthcare Provider Details

I. General information

NPI: 1972668374
Provider Name (Legal Business Name): RICHARD C KAISER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 NORTH RD STE 204
BEDFORD MA
01730-1037
US

IV. Provider business mailing address

11 BEVERLY RD
BEDFORD MA
01730-1136
US

V. Phone/Fax

Practice location:
  • Phone: 781-778-0017
  • Fax: 781-778-0097
Mailing address:
  • Phone: 781-778-0017
  • Fax: 978-287-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD C KAISER
Title or Position: CEO
Credential: MD
Phone: 781-778-0017