Provider Demographics
NPI:1003953472
Name:ARENSON, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:ARENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PELHAM PKWY S
Mailing Address - Street 2:SUITE 3-G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1019
Mailing Address - Country:US
Mailing Address - Phone:718-823-0114
Mailing Address - Fax:
Practice Address - Street 1:1130 PELHAM PKWY S
Practice Address - Street 2:SUITE 3-G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1019
Practice Address - Country:US
Practice Address - Phone:718-823-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1559842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09G891Medicare ID - Type Unspecified