Provider Demographics
NPI:1063441756
Name:ANGRIST, RICHARD C (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:ANGRIST
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 1:1527 STATE ROUTE 27
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4017
Mailing Address - Country:US
Mailing Address - Phone:732-246-1050
Mailing Address - Fax:732-846-1440
Practice Address - Street 1:1527 STATE ROUTE 27
Practice Address - Street 2:SUITE 2600
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4017
Practice Address - Country:US
Practice Address - Phone:732-246-1050
Practice Address - Fax:732-846-1440
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04389500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3251101Medicaid
NJ3251101Medicaid
NJB10550Medicare UPIN