Individual
DR. RICHARD A LICHTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1999 SPROUL RD, STE 21, BROOMALL, PA 19008-3508
(610) 353-6400
(610) 356-1204
Mailing address
1999 SPROUL RD, STE 21, BROOMALL, PA 19008-3508
(610) 353-6400
(610) 356-1204
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD018781E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007336900002
—
PA
01
—
0031373000
KEYSTONE
PA
01
—
131926
BLUE SHIELD
PA
01
—
58229
AETNA
PA
01
—
CF6196
RAILROAD MEDICARE
PA
Enumeration date
06/09/2005
Last updated
01/23/2008
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