MEDICARE: RICHARD GOTTFRIED MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	166557	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	44F07	OTHER	NY	MEDICARE
3	110142529	OTHER	NY	RAILRAOD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023094323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD GOTTFRIED MD

Provider Business Mailing Address
First Line	:	1296 NORTH AVE
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-2603
Country	:	US
Telephone Number	:	914-235-8224
Fax Number	:	914-235-6940

Provider Business Practice Location Address
First Line	:	1296 NORTH AVE
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-2603
Country	:	US
Telephone Number	:	914-235-8224
Fax Number	:	914-235-6940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	10/26/2015

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Directions to “ RICHARD GOTTFRIED MD” Practice Location

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