Provider Demographics
NPI:1538803366
Name:RICHMOND, THERESA L
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 W 87TH ST APT 4G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2848
Mailing Address - Country:US
Mailing Address - Phone:917-533-9872
Mailing Address - Fax:
Practice Address - Street 1:247 W 87TH ST APT 4G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2848
Practice Address - Country:US
Practice Address - Phone:917-533-9872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula