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General NPI Number Information
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NPI Number | 1194045757
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Entity Type | Organization
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Legal Business Name | RICHARD NATHANSON, M.D., PLLC
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Dates
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Enumeration Date | 06/07/2010
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 220 5TH AVE FL 11
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City | NEW YORK
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State | NY
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Zip | 10001-8017
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Country | US
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Telephone | 646-722-8134
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Fax |
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Provider Business Mailing Address
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Address Line | 220 5TH AVE FL 11
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City | NEW YORK
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State | NY
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Zip | 10001-8017
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Country | US
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Telephone | 646-722-8134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD ANDREW NATHANSON
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Credential | M.D.
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Telephone | 646-722-8134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 218413
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License Number State | NY
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