Healthcare Provider Details

I. General information

NPI: 1427400449
Provider Name (Legal Business Name): RICHARD DAVID CLAUSELL RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2016
Last Update Date: 07/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 WILLIAM ST
BOONTON NJ
07005-1822
US

IV. Provider business mailing address

427 WILLIAM ST
BOONTON NJ
07005-1822
US

V. Phone/Fax

Practice location:
  • Phone: 201-470-2273
  • Fax:
Mailing address:
  • Phone: 201-470-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number43ZA00497600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT14233
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: