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Individual

CARL RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14556 229TH ST, SPRINGFIELD GARDENS, NY 11413-3923
(800) 313-7591
(718) 949-6315
Mailing address
14556 229TH ST, SPRINGFIELD GARDENS, NY 11413-3923
(800) 313-7591
(718) 949-6315

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NY

Other

Enumeration date
07/22/2019
Last updated
07/22/2019
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