Healthcare Provider Details

I. General information

NPI: 1205183993
Provider Name (Legal Business Name): RICHARD B ADAMS NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 HAMBURG TPKE SUITE 201
WAYNE NJ
07470-2156
US

IV. Provider business mailing address

246 HAMBURG TPKE SUITE 201
WAYNE NJ
07470-2156
US

V. Phone/Fax

Practice location:
  • Phone: 973-942-1141
  • Fax: 973-942-1250
Mailing address:
  • Phone: 973-942-1141
  • Fax: 973-942-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00367700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: