MEDICARE: RICHMOND PHYSICIAN ASSOCIATES PC

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	2084P0800X	Psychiatry Physician		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	:	1861590267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND PHYSICIAN ASSOCIATES PC

Provider Business Mailing Address
First Line	:	75 VANDERBILT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2604
Country	:	US
Telephone Number	:	718-818-5344
Fax Number	:	212-356-4608

Provider Business Practice Location Address
First Line	:	75 VANDERBILT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2604
Country	:	US
Telephone Number	:	718-818-5344
Fax Number	:	212-356-4608

Authorized Official
Title or Position	:	CHIEF
Name	:	DR. NARENDRA PATEL
Credential	:	MD
Telephone Number	:	718-818-5344

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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