Healthcare Provider Details

I. General information

NPI: 1720261969
Provider Name (Legal Business Name): RICHARD CUMMINGS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HADJIS WAY SUITE 2
LAKE PLACID NY
12946-1270
US

IV. Provider business mailing address

45 HADJIS WAY SUITE 2
LAKE PLACID NY
12946-1270
US

V. Phone/Fax

Practice location:
  • Phone: 518-523-2011
  • Fax:
Mailing address:
  • Phone: 518-523-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number033255
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: