MEDICARE: DAVID M RICHLIN M.D.

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	174400000X	Specialist	05879500	NJ
2	207L00000X	Anesthesiology Physician	MD050521L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DF2815	OTHER	PA	RAILROAD MEDICARE GROUP
3	P00427802	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1093718934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M RICHLIN M.D.

Provider Business Mailing Address
First Line	:	11781 LEE JACKSON MEMORIAL HWY
Second Line	:	SUITE 550
City	:	FAIRFAX
State	:	VA
Zip	:	22033-3309
Country	:	US
Telephone Number	:	571-777-5102
Fax Number	:	703-563-6256

Provider Business Practice Location Address
First Line	:	206 E BROWN ST
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18301-3006
Country	:	US
Telephone Number	:	570-421-4000
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/15/2015

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Directions to “ DAVID M RICHLIN M.D.” Practice Location

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