Provider Demographics
NPI:1730255647
Name:RICHTER, DAVID MARTIN (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARTIN
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 EAST 11 STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-4134
Mailing Address - Country:US
Mailing Address - Phone:212-228-1884
Mailing Address - Fax:516-791-5286
Practice Address - Street 1:645 EAST 11 STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-4134
Practice Address - Country:US
Practice Address - Phone:212-228-1884
Practice Address - Fax:516-791-5286
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002168213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413323Medicaid
T50678Medicare UPIN
NYDROP2001Medicare ID - Type Unspecified