Healthcare Provider Details

I. General information

NPI: 1649232158
Provider Name (Legal Business Name): DARREN A RICH O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607A LOUIS DR
WARMINSTER PA
18974-2832
US

IV. Provider business mailing address

25 NEEDHAM ST
NEWTON MA
02461-1615
US

V. Phone/Fax

Practice location:
  • Phone: 215-675-3005
  • Fax:
Mailing address:
  • Phone: 617-964-6681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000204
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: