Provider Demographics
NPI:1770846925
Name:RICHTER, MARCIE K (MSED)
Entity Type:Individual
Prefix:MS
First Name:MARCIE
Middle Name:K
Last Name:RICHTER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RICHLEE CT
Mailing Address - Street 2:APT. 4S
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3632
Mailing Address - Country:US
Mailing Address - Phone:631-804-5875
Mailing Address - Fax:
Practice Address - Street 1:12 RICHLEE CT
Practice Address - Street 2:APT. 4S
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3632
Practice Address - Country:US
Practice Address - Phone:631-804-5875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1097751174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1097751OtherSPECIAL EDUCATION TEACHER