Provider Demographics
NPI:1962720680
Name:RICHMAN, OREN (DDS, MD)
Entity type:Individual
Prefix:
First Name:OREN
Middle Name:
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NASSAU UNIVERSITY MEDICAL CENTER, DEPT OF ORAL SURGERY
Mailing Address - Street 2:2201 HEMPSTEAD TPKE
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-572-6895
Mailing Address - Fax:
Practice Address - Street 1:NASSAU UNIVERSITY MEDICAL CENTER, DEPT OF ORAL SURGERY
Practice Address - Street 2:2201 HEMPSTEAD TPKE
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554
Practice Address - Country:US
Practice Address - Phone:516-572-6895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052884204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03596985Medicaid