MEDICARE: RENEE RICHARDS 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	207W00000X	Ophthalmology Physician	084322-1	NY

General Provider Information

NPI Number	:	1699786913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE RICHARDS M.D.

Provider Business Mailing Address
First Line	:	2649 STRANG BLVD
Second Line	:	SUITE 203
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-2939
Country	:	US
Telephone Number	:	914-962-0684
Fax Number	:	914-962-0415

Provider Business Practice Location Address
First Line	:	2649 STRANG BLVD
Second Line	:	SUITE 203
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-2939
Country	:	US
Telephone Number	:	914-962-0684
Fax Number	:	914-962-0415

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	09/21/2012

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