Healthcare Provider Details

I. General information

NPI: 1104813765
Provider Name (Legal Business Name): RICHARD A PARISI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5424 DISCOVERY PARK BLVD 204
WILLIAMSBURG VA
23188
US

IV. Provider business mailing address

860 OMNI BLVD STE 101
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-707-3999
  • Fax: 757-707-3993
Mailing address:
  • Phone: 757-232-8769
  • Fax: 757-232-8875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number0101840565
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: