Healthcare Provider Details

I. General information

NPI: 1346689510
Provider Name (Legal Business Name): ANIKA RICHARDS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S OAK DR
BRONX NY
10467-6517
US

IV. Provider business mailing address

811 S OAK DR
BRONX NY
10467-6517
US

V. Phone/Fax

Practice location:
  • Phone: 914-357-9715
  • Fax: 914-560-2257
Mailing address:
  • Phone: 914-357-9715
  • Fax: 914-560-2257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number291147
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number291147
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number291147
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: