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Individual
MR. P RICHARD FAUTH
Active
Individual
MR. P RICHARD FAUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0093281
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01109737
—
NY
01
—
4580504
AETNA
—
Enumeration date
11/22/2006
Last updated
07/08/2007
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