Basic Information
| Provider Information | |||||||||
| NPI: | 1497905780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDS | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | JANICE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11587 220TH ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIA HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114111164 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 760 BROADWAY, AMBULATORY CARE | ||||||||
| Address2: | WOODHULL MEDICAL & MENTAL HEALTH CENTER | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189638000 | ||||||||
| FaxNumber: | 7186303122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2008 | ||||||||
| LastUpdateDate: | 07/25/2016 | ||||||||
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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 | 207R00000X | 266263 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 242345 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.