Healthcare Provider Details

I. General information

NPI: 1659234094
Provider Name (Legal Business Name): DANIELA RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 E 98TH ST APT 2E
BROOKLYN NY
11236-1344
US

IV. Provider business mailing address

PO BOX 210894
BROOKLYN NY
11221-0894
US

V. Phone/Fax

Practice location:
  • Phone: 718-669-8883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number845106
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: