Individual
DR. RICHARD G ETRA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
560 NORTHERN BLVD, GREAT NECK, NY 11021-5100
(516) 487-6200
(516) 487-6329
Mailing address
175 JERICHO TPKE, SYOSSET, NY 11791-4532
(516) 622-6000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
128003
NY
Other
Enumeration date
12/07/2005
Last updated
09/24/2015
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