Basic Information
| Provider Information | |||||||||
| NPI: | 1881624120 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GHARI RICHARDSON MD FOA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 388 | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671140388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162813700 | ||||||||
| FaxNumber: | 3162824322 | ||||||||
| Practice Location | |||||||||
| Address1: | 427 GUY PARK AVE | ||||||||
| Address2: | |||||||||
| City: | AMSTERDAM | ||||||||
| State: | NY | ||||||||
| PostalCode: | 120101054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188417102 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 09/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | RICHARDSON | ||||||||
| AuthorizedOfficialFirstName: | GHARI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5188417102 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.