Healthcare Provider Details

I. General information

NPI: 1306549225
Provider Name (Legal Business Name): RICHA MUDWARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MAIN ST
PATERSON NJ
07503-2621
US

IV. Provider business mailing address

240 CHUBB AVE APT 333
LYNDHURST NJ
07071-3555
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-2543
  • Fax:
Mailing address:
  • Phone: 240-608-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA13071400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: