Individual
RICHARD LARSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12 S MAIN ST, FRANKLINVILLE, NY 14737-1224
(716) 676-2212
(716) 676-2432
Mailing address
535 MAIN ST, OLEAN, NY 14760-1513
(716) 372-0141
(716) 372-6421
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003239
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02220780
—
NY
Enumeration date
07/21/2005
Last updated
02/16/2012
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