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General NPI Number Information
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NPI Number | 1659938959
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Entity Type | Individual
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Provider Name | TONY RICHA MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | ELM AND CARLTON STREETS HEAD AND NECK SURGICAL ONCOLOGY
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City | BUFFALO
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State | NY
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Zip | 14263-0001
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Country | US
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Telephone | 716-845-4898
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 LOCUST ST APT 1102
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5651
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Country | US
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Telephone | 267-401-2995
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 100234-01
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License Number State | NY
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