Provider Demographics
NPI:1164549093
Name:RICHMOND OBGYN ASSOCIATES PC
Entity Type:Organization
Organization Name:RICHMOND OBGYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-351-1350
Mailing Address - Street 1:5 CODDINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4305
Mailing Address - Country:US
Mailing Address - Phone:718-351-1350
Mailing Address - Fax:718-351-1271
Practice Address - Street 1:5 CODDINGTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4305
Practice Address - Country:US
Practice Address - Phone:718-351-1350
Practice Address - Fax:718-351-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-24
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144422174400000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty