Provider Demographics
NPI:1609923697
Name:RICHLESS, LLOYD K (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:K
Last Name:RICHLESS
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 1:251 7TH ST
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6534
Mailing Address - Country:US
Mailing Address - Phone:724-335-6662
Mailing Address - Fax:724-335-3010
Practice Address - Street 1:251 7TH ST
Practice Address - Street 2:SUITE 201B
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6534
Practice Address - Country:US
Practice Address - Phone:724-335-6662
Practice Address - Fax:724-335-3010
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 027711E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA252044OtherUPMC
PA306284OtherHEALTH ASSURANCE
PA461863OtherBC BS
PA466675OtherAETNA US HEALTHCARE
PA1006735OtherGATEWAY
PA1021909Medicaid
PA1021909Medicaid
PA1006735OtherGATEWAY