Provider Demographics
NPI:1346813615
Name:RICHARDS, PEGGY W (MA EDUCATION)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:W
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1334
Mailing Address - Country:US
Mailing Address - Phone:315-729-5457
Mailing Address - Fax:
Practice Address - Street 1:192 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-1334
Practice Address - Country:US
Practice Address - Phone:315-729-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist