1063400398 NPI number — CAROL M RICHMAN PH.D.

Table of content: CAROL M RICHMAN PH.D. (NPI 1063400398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063400398 NPI number — CAROL M RICHMAN PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHMAN
Provider First Name:
CAROL
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

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:
1063400398
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2939 DENBEIGH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HATFIELD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19440-2868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-664-0233
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
246 W BROAD ST
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
QUAKERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18951-1244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-536-2656
Provider Business Practice Location Address Fax Number:
215-536-2659
Provider Enumeration Date:
10/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PS006166L , 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)

  • Identifier: 01891401 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0688908000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 150184000 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7347014 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 520842 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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