Healthcare Provider Details

I. General information

NPI: 1487617775
Provider Name (Legal Business Name): RICHARD IRVING NETSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2006
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 DERBY ST STE 7
HINGHAM MA
02043-4021
US

IV. Provider business mailing address

12 BURNLEY RD
NORWOOD MA
02062-1103
US

V. Phone/Fax

Practice location:
  • Phone: 617-876-4099
  • Fax: 781-740-0233
Mailing address:
  • Phone: 671-365-2047
  • Fax: 781-740-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number41214
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number41214
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: