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NPI Code Detail

MEDICARE: MRS. JOHANN ANDRIA RICHARDSON

MEDICARE: MRS. JOHANN ANDRIA RICHARDSON
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
1171M00000XCase Manager/Care Coordinator16009NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770839011
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOHANN ANDRIA RICHARDSON
Provider Business Mailing Address
First Line : 14556 229TH ST
Second Line :
City : SPRINGFIELD GARDENS
State : NY
Zip : 11413-3923
Country : US
Telephone Number : 718-813-7579
Fax Number : 718-949-6315
Provider Business Practice Location Address
First Line : 827 CLARKSON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2256
Country : US
Telephone Number : 718-735-7151
Fax Number : 718-735-7141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2012
Last Update Date : 07/24/2012

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