Provider Demographics
NPI:1083613384
Name:RICHLER, MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:RICHLER
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 1:20 HOPE AVE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-2721
Mailing Address - Country:US
Mailing Address - Phone:781-891-1447
Mailing Address - Fax:781-891-7936
Practice Address - Street 1:20 HOPE AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-2721
Practice Address - Country:US
Practice Address - Phone:781-891-1447
Practice Address - Fax:781-891-7936
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71402207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3081541Medicaid
MA0800472OtherEVERCARE
MA26488OtherFALLON HEALTH PLAN
MA071402OtherTUFTS HEALTH PLAN
MA0023065OtherNEIGHBORHOOD HEALTH PLAN
MA08-00598OtherUNITED HEALTHCARE
MA151644OtherHARVARD PILGRIM HEALTH
MA2100123OtherUS HEALTHCARE
MAB20543204OtherCIGNA HEALTH CARE
MA3081541Medicaid
MA0023065OtherNEIGHBORHOOD HEALTH PLAN