Individual
DR. RICHARD I MINTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7622 OGONTZ AVE, PHILADELPHIA, PA 19150-1817
(215) 224-8980
(215) 224-9342
Mailing address
7622 OGONTZ AVE, PHILADELPHIA, PA 19150-1817
(215) 224-8980
(215) 224-9342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0S003583L
PA
207RC0000X
Cardiovascular Disease Physician
Primary
0S003583L
PA
207RC0000X
Cardiovascular Disease Physician
25MB05998400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008238500001
DPA
—
01
—
0008238500005
DPA
—
01
—
0055111000
KE65
—
01
—
0055111001
PC
—
01
—
0060155000
KE65
—
01
—
0060155001
KEY
—
01
—
01821
SRHP
—
01
—
018210S003583L
HLTHD
—
01
—
1034655
KMHP
—
01
—
161767
BS
—
01
—
P00087018
RRMED
—
Enumeration date
07/17/2006
Last updated
04/24/2008
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