Provider Demographics
NPI:1699786913
Name:RICHARDS, RENEE (MD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:RICHARDS
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 1:2649 STRANG BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2939
Mailing Address - Country:US
Mailing Address - Phone:914-962-0684
Mailing Address - Fax:914-962-0415
Practice Address - Street 1:2649 STRANG BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2939
Practice Address - Country:US
Practice Address - Phone:914-962-0684
Practice Address - Fax:914-962-0415
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084322-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC06629Medicare UPIN
NYRR01960110Medicare PIN