Provider Demographics
NPI:1215035456
Name:BUCKLEY, RICHARD EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EARL
Last Name:BUCKLEY
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 1:303 W HARFORD ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1116
Mailing Address - Country:US
Mailing Address - Phone:570-296-4000
Mailing Address - Fax:
Practice Address - Street 1:303 W HARFORD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1116
Practice Address - Country:US
Practice Address - Phone:570-296-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035550-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD035550-EOtherMD
PA110043312OtherMEDICARE RR
PA197773OtherBSPA
PA110043312OtherMEDICARE RR
PAC33333Medicare UPIN