Provider Demographics
NPI:1679278717
Name:VACA, RICHARD GUILLERMO SR (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:GUILLERMO
Last Name:VACA
Suffix:SR
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 1:281 1ST AVENUE MOUNT SINAI BETH ISRAEL HOSPITAL CENTER,
Mailing Address - Street 2:DEPARTMENT OF MEDICINE-BAIRD HALL 20TH FLR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2925
Mailing Address - Country:US
Mailing Address - Phone:212-420-3391
Mailing Address - Fax:212-420-4615
Practice Address - Street 1:281 1ST AVENUE MOUNT SINAI BETH ISRAEL HOSPITAL CENTER,
Practice Address - Street 2:DEPARTMENT OF MEDICINE-BAIRD HALL 20TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2925
Practice Address - Country:US
Practice Address - Phone:212-420-3391
Practice Address - Fax:212-420-4615
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program