Provider Demographics
NPI:1194790014
Name:CHARNEY, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:CHARNEY
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 1:175 MEMORIAL HWY STE 1-1
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5639
Mailing Address - Country:US
Mailing Address - Phone:914-235-3535
Mailing Address - Fax:914-235-4108
Practice Address - Street 1:175 MEMORIAL HWY STE 1-1
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5639
Practice Address - Country:US
Practice Address - Phone:914-235-3535
Practice Address - Fax:914-235-4108
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171339207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01347704Medicaid
NY47K2621351OtherMEDICARE
NY47K2621351OtherMEDICARE
F22005Medicare UPIN