Provider Demographics
NPI:1528021284
Name:CHRISTOPH, RICHARD P
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:CHRISTOPH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1902
Mailing Address - Country:US
Mailing Address - Phone:610-921-1638
Mailing Address - Fax:610-921-2926
Practice Address - Street 1:1806 SWAMP PIKE STE 400
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9307
Practice Address - Country:US
Practice Address - Phone:610-323-4445
Practice Address - Fax:610-323-4377
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001619152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU41595Medicare UPIN
PACH480386Medicare ID - Type Unspecified