MEDICARE: MS. KRISTY E RICHARD FNP

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	363LF0000X	Family Nurse Practitioner	336515	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	405977	NY

General Provider Information

NPI Number	:	1437425667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTY E RICHARD FNP

Provider Business Mailing Address
First Line	:	241 W 57TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-2121
Country	:	US
Telephone Number	:	718-332-8425
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 W MERRICK RD STE 201D
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-3743
Country	:	US
Telephone Number	:	516-452-5867
Fax Number	:

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

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	04/22/2026

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