MEDICARE: DR. ALAN M RICHARDS PH.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	231H00000X	Audiologist	000009	NY

General Provider Information

NPI Number	:	1770587214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN M RICHARDS PH.D.

Provider Business Mailing Address
First Line	:	70 GLEN COVE RD
Second Line	:	STE LL5
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1722
Country	:	US
Telephone Number	:	212-722-8100
Fax Number	:	212-828-9570

Provider Business Practice Location Address
First Line	:	70 GLEN COVE RD
Second Line	:	STE LL5
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1722
Country	:	US
Telephone Number	:	516-625-1400
Fax Number	:	516-821-8558

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	10/21/2016

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