Provider Demographics
NPI:1063417566
Name:NAUHEIM, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:NAUHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3146
Mailing Address - Country:US
Mailing Address - Phone:516-868-7110
Mailing Address - Fax:516-868-7380
Practice Address - Street 1:2025 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3146
Practice Address - Country:US
Practice Address - Phone:516-868-7110
Practice Address - Fax:516-868-7380
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162799207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01190876Medicaid
22F821Medicare ID - Type Unspecified
E17238Medicare UPIN