Provider Demographics
NPI:1932389657
Name:RICH, MAURICE P (RPT)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:P
Last Name:RICH
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 ROTHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-4817
Mailing Address - Country:US
Mailing Address - Phone:215-439-5563
Mailing Address - Fax:
Practice Address - Street 1:1461 ROTHLEY AVE
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-4817
Practice Address - Country:US
Practice Address - Phone:215-439-5563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003763L171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001273601OtherPROVIDER NUMBER