Provider Demographics
NPI:1073582813
Name:MILLS, RICHARD JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:MILLS
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 1:72 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3986
Mailing Address - Country:US
Mailing Address - Phone:732-541-2233
Mailing Address - Fax:732-541-2234
Practice Address - Street 1:72 ROUTE 27
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3986
Practice Address - Country:US
Practice Address - Phone:732-541-2233
Practice Address - Fax:732-541-2234
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA057818002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6086101Medicaid
NJ5343570001Medicare NSC
NJ6086101Medicaid
NJ6086101Medicaid