Provider Demographics
NPI:1104977461
Name:FIRSHEIN, RICHARD N (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:N
Last Name:FIRSHEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1230 PARK AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1724
Mailing Address - Country:US
Mailing Address - Phone:212-860-0282
Mailing Address - Fax:212-860-0276
Practice Address - Street 1:1230 PARK AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1724
Practice Address - Country:US
Practice Address - Phone:212-860-0282
Practice Address - Fax:212-860-0276
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167628-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03E701Medicare ID - Type Unspecified
NYE61195Medicare UPIN