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NPI Code Detail

MEDICARE: ETHAN JAMES RICHMAN MD

MEDICARE: ETHAN JAMES RICHMAN 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073451993
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHAN JAMES RICHMAN MD
Provider Business Mailing Address
First Line : 1000 10TH AVE STE 3A-08
Second Line :
City : NEW YORK
State : NY
Zip : 10019-1147
Country : US
Telephone Number : 212-259-6777
Fax Number :
Provider Business Practice Location Address
First Line : 1000 10TH AVE STE 3A-08
Second Line :
City : NEW YORK
State : NY
Zip : 10019-1147
Country : US
Telephone Number : 212-259-6777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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