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General NPI Number Information
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NPI Number | 1487301164
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Entity Type | Individual
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Provider Name | KEVIN RICH NP
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Gender | Male
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 150 MOTOR PKWY STE 401
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City | HAUPPAUGE
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State | NY
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Zip | 11788-5108
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Country | US
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Telephone | 631-238-1509
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Fax | 631-980-3686
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Provider Business Mailing Address
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Address Line | 28 WINDSOR ST
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City | CENTEREACH
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State | NY
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Zip | 11720-4206
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Country | US
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Telephone | 631-478-9763
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Fax | 631-980-3686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 403050
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License Number State | NY
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