MEDICARE: DR. NEAL RICHMOND 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	207P00000X	Emergency Medicine Physician	39664	KY
2	207P00000X	Emergency Medicine Physician	189250	NY
3	207P00000X	Emergency Medicine Physician	58773	TN

General Provider Information

NPI Number	:	1881758993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL RICHMOND M.D.

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-922-1900
Fax Number	:	585-922-1011

Provider Business Practice Location Address
First Line	:	1425 PORTLAND AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3095
Country	:	US
Telephone Number	:	585-922-2000
Fax Number	:	585-922-2951

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	09/09/2025

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