Provider Demographics
NPI:1215465869
Name:RICHARD, CHRISTOPHER EDMUND (MED)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:EDMUND
Last Name:RICHARD
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CANAL ST APT D
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-2632
Mailing Address - Country:US
Mailing Address - Phone:603-969-6604
Mailing Address - Fax:
Practice Address - Street 1:37 CANAL ST APT D
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-2632
Practice Address - Country:US
Practice Address - Phone:603-969-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst