Healthcare Provider Details

I. General information

NPI: 1285614107
Provider Name (Legal Business Name): MICHAEL RICHHEIMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 MANHATTAN AVE
BROOKLYN NY
11222-5840
US

IV. Provider business mailing address

8714 5TH AVE
BROOKLYN NY
11209-5204
US

V. Phone/Fax

Practice location:
  • Phone: 718-383-3377
  • Fax: 718-383-3606
Mailing address:
  • Phone: 718-748-2900
  • Fax: 718-748-9365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number174519
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number174519
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: