Provider Demographics
NPI:1376591628
Name:RICHMOND, JOHN STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:RICHMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:52 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1814
Mailing Address - Country:US
Mailing Address - Phone:914-666-2220
Mailing Address - Fax:914-666-2987
Practice Address - Street 1:52 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1814
Practice Address - Country:US
Practice Address - Phone:914-666-2220
Practice Address - Fax:914-666-2987
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1865072085R0204X
NJ25MA067667002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology