Provider Demographics
NPI:1699773473
Name:RICHIE, ALISHIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:ALISHIA
Middle Name:ANN
Last Name:RICHIE
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 1:2476 SWEDESFORD RD STE 150
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1456
Mailing Address - Country:US
Mailing Address - Phone:844-902-2345
Mailing Address - Fax:
Practice Address - Street 1:1080 N DELAWARE AVE STE 800
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4338
Practice Address - Country:US
Practice Address - Phone:267-463-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD42086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0223115Medicaid
NJ60059975OtherHORIZON NJ HEALTH
NJ204133180OtherUNITED HEALTH CARE CCP
093399OtherMEDICARE
I37545Medicare UPIN