Provider Demographics
NPI:1316270606
Name:RICHMAN, BEVERLY LINDA (MD)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:LINDA
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 64TH ST APT 19K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7514
Mailing Address - Country:US
Mailing Address - Phone:212-758-5894
Mailing Address - Fax:
Practice Address - Street 1:340 E 64TH ST APT 19K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7514
Practice Address - Country:US
Practice Address - Phone:212-758-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY674781Medicare PIN
NYE44984Medicare UPIN