Provider Demographics
NPI:1720009368
Name:ISRAEL, RICHARD H (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-589-3277
Mailing Address - Fax:301-589-3632
Practice Address - Street 1:2101 MEDICAL PARK DR
Practice Address - Street 2:SUITE 211
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-589-3277
Practice Address - Fax:301-589-3632
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00014231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1199 0001OtherCAREFIRST
MD41550401OtherCAREFIRST
DC201746YB52OtherMEDICARE
GA640000285OtherRAILROAD MEDICARE
DC201746YB52OtherMEDICARE