MEDICARE: DR. RICARDO E POU 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	207RG0100X	Gastroenterology Physician	192097	NY

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	:	1396847976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO E POU M.D.

Provider Business Mailing Address
First Line	:	300 FORT WASHINGTON AVE OFC 1
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1323
Country	:	US
Telephone Number	:	212-316-3276
Fax Number	:	212-568-3688

Provider Business Practice Location Address
First Line	:	300 FORT WASHINGTON AVE OFC 1
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1323
Country	:	US
Telephone Number	:	212-316-3276
Fax Number	:	212-568-3688

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	03/16/2020

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