Basic Information
| Provider Information | |||||||||
| NPI: | 1477523405 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOMMERFIELD | ||||||||
| FirstName: | RICHELLE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WELLNESS WAY | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153019706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242506001 | ||||||||
| FaxNumber: | 7242506004 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 WELLNESS WAY | ||||||||
| Address2: | BLDG 2 | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153019706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242506001 | ||||||||
| FaxNumber: | 7242506004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 08/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD422738 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 101013202 | 05 | PA | MEDICAID |