Healthcare Provider Details

I. General information

NPI: 1609978329
Provider Name (Legal Business Name): MICHAEL LLOYD RICHTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MICHAEL L RICHTER MD

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 15 63RD DRIVE
REGO PARK NY
11374
US

IV. Provider business mailing address

92 15 63RD DRIVE
REGO PARK NY
11374
US

V. Phone/Fax

Practice location:
  • Phone: 718-897-6223
  • Fax: 718-897-6215
Mailing address:
  • Phone: 718-897-6223
  • Fax: 718-897-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number049755
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number142859
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number188671
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: