Provider Demographics
NPI:1619958311
Name:ADAMS, RICHARD N JR (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:N
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ERIN AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901
Mailing Address - Country:US
Mailing Address - Phone:518-578-9849
Mailing Address - Fax:
Practice Address - Street 1:26 ERIN AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2404
Practice Address - Country:US
Practice Address - Phone:518-578-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2007-04-02
Provider Licenses
StateLicense IDTaxonomies
NY142256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00964287Medicaid
NYDO2299Medicare UPIN
NY00964287Medicaid