Healthcare Provider Details

I. General information

NPI: 1710048277
Provider Name (Legal Business Name): RICHARD LINK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 FROST ST
BROOKLYN NY
11211-1404
US

IV. Provider business mailing address

170 FROST ST
BROOKLYN NY
11211-1404
US

V. Phone/Fax

Practice location:
  • Phone: 718-388-6629
  • Fax:
Mailing address:
  • Phone: 718-388-6629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number129171
License Number StateNY

VIII. Authorized Official

Name: RICHARD LINK
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 718-388-6629