Healthcare Provider Details
I. General information
NPI: 1063419950
Provider Name (Legal Business Name): RICHARD W STRECKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
169 LINCOLN ST STE 201
HINGHAM MA
02043-4640
US
IV. Provider business mailing address
751 CHIEF JUSTICE CUSHING HWY
COHASSET MA
02025-2115
US
V. Phone/Fax
- Phone: 781-383-2555
- Fax: 781-383-6660
- Phone: 508-754-3566
- Fax: 508-438-6368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 58807 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: