Provider Demographics
NPI:1972569663
Name:NERI, RICHARD C
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:NERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228
Mailing Address - Country:US
Mailing Address - Phone:716-564-2148
Mailing Address - Fax:716-691-4325
Practice Address - Street 1:2825 NIAGARA FALLS BLVD
Practice Address - Street 2:STE 120
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228
Practice Address - Country:US
Practice Address - Phone:716-564-2148
Practice Address - Fax:716-691-4325
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133075207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00647118Medicaid
NY0707754OtherINDEPENDENT HEALTH
NY000507896002OtherBCBS CBL
NY000507896002OtherBCBS CBL
NY0707754OtherINDEPENDENT HEALTH