Provider Demographics
NPI:1548224108
Name:RICHARD, JAMES T (EDD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:RICHARD
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 NEWTOWN-YARDLEY RD.,
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1759
Mailing Address - Country:US
Mailing Address - Phone:215-968-5378
Mailing Address - Fax:215-355-5142
Practice Address - Street 1:660 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1759
Practice Address - Country:US
Practice Address - Phone:215-968-5378
Practice Address - Fax:215-355-5142
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS000045-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0023680000OtherIBC PERSONAL CHOICE
RI029735Medicare ID - Type Unspecified