Provider Demographics
NPI:1679749071
Name:PATHAK, RICHA (MD)
Entity Type:Individual
Prefix:
First Name:RICHA
Middle Name:
Last Name:PATHAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 OVINGTON AVE
Mailing Address - Street 2:6-C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1758
Mailing Address - Country:US
Mailing Address - Phone:718-238-1908
Mailing Address - Fax:
Practice Address - Street 1:515 OVINGTON AVE
Practice Address - Street 2:6-C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1758
Practice Address - Country:US
Practice Address - Phone:718-238-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program