1578790945 NPI number — STEPHANIE S. RICHARDS, MD LLC

Table of content: (NPI 1578790945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578790945 NPI number — STEPHANIE S. RICHARDS, MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHANIE S. RICHARDS, MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578790945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 BRAUNLICH DR
Provider Second Line Business Mailing Address:
MCKNIGHT PLAZA, SUITE 480
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15237-3348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-358-8666
Provider Business Mailing Address Fax Number:
412-358-8684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 BRAUNLICH DR
Provider Second Line Business Practice Location Address:
MCKNIGHT PLAZA, SUITE 480
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-3348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-358-8666
Provider Business Practice Location Address Fax Number:
412-358-8684
Provider Enumeration Date:
06/12/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RICHARDS
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
412-358-8666

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  MD056113L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)