1770594715 NPI number — EDWIN F RICHTER III MD

Table of content: EDWIN F RICHTER III MD (NPI 1770594715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770594715 NPI number — EDWIN F RICHTER III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHTER
Provider First Name:
EDWIN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1770594715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 HOSPITAL PLAZA
Provider Second Line Business Mailing Address:
STE 495
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06902-3602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-316-0610
Provider Business Mailing Address Fax Number:
203-969-7418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 HOSPITAL PLAZA
Provider Second Line Business Practice Location Address:
STE 495
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06902-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-316-0610
Provider Business Practice Location Address Fax Number:
203-969-7418
Provider Enumeration Date:
08/11/2006

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: 208100000X , with the licence number:  043144 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001431444 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: TIN . This is a "POMCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4522972007 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "FOCUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "CORVEL" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "NATIONAL PROVIDER NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "NEHD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3880662 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P3600729 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010043144CT01 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 043144 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1371J . This is a "EMPIRE BC/BS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V6536 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "PIONEER" identifier . This identifiers is of the category "OTHER".
  • Identifier: TIN . This is a "PHCS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com