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General NPI Number Information
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NPI Number | 1730218363
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Entity Type | Organization
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Legal Business Name | RICHMOND TOTAL MEDICAL, P.C.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1776 RICHMOND RD SUITE 5
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2581
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Country | US
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Telephone | 718-668-9300
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Fax | 718-668-1834
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Provider Business Mailing Address
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Address Line | 131 HILLSIDE TER
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2819
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Country | US
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Telephone | 718-317-5960
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Fax | 718-317-5961
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DOMINICK MCCARTHY
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Credential | D.O.
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Telephone | 718-317-5960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 211722
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License Number State | NY
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