Healthcare Provider Details

I. General information

NPI: 1366449886
Provider Name (Legal Business Name): KENNETH ALLEN RICHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 NORTH 39TH STREET 2ND FL. WRIGHT/SAUNDERS W223
PHILADELPHIA PA
19104-2640
US

IV. Provider business mailing address

51 NORTH 39TH STREET 2ND FL. WRIGHT/SAUNDERS W223
PHILADELPHIA PA
19104-2640
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-8244
  • Fax: 215-545-1543
Mailing address:
  • Phone: 215-662-8244
  • Fax: 215-545-1543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD016633E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: