Provider Demographics
NPI:1194086090
Name:RICHARDS, RASHIDA (SI)
Entity type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:SI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 MCLEAN AVE
Mailing Address - Street 2:SUITE 219
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4105
Mailing Address - Country:US
Mailing Address - Phone:917-701-1273
Mailing Address - Fax:
Practice Address - Street 1:976 MCLEAN AVE
Practice Address - Street 2:SUITE 219
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-4105
Practice Address - Country:US
Practice Address - Phone:917-701-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist