Healthcare Provider Details

I. General information

NPI: 1578800751
Provider Name (Legal Business Name): ERIN FRANCES RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 RED LION RD STE 214
PHILADELPHIA PA
19114-1440
US

IV. Provider business mailing address

2500 MARYLAND RD STE 504
WILLOW GROVE PA
19090-1226
US

V. Phone/Fax

Practice location:
  • Phone: 215-612-5050
  • Fax: 215-612-5214
Mailing address:
  • Phone: 215-481-6872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA051825
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: