Healthcare Provider Details

I. General information

NPI: 1841488038
Provider Name (Legal Business Name): RICHMOND AMBULATORY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2348 RICHMOND RD SUB LEVEL
STATEN ISLAND NY
10306-2346
US

IV. Provider business mailing address

2348 RICHMOND RD
STATEN ISLAND NY
10306-2346
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-3577
  • Fax: 718-667-3043
Mailing address:
  • Phone: 718-667-3577
  • Fax: 718-667-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH B CHAPMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 718-667-3577