Provider Demographics
NPI:1821261470
Name:RICHTER, ALLISHA NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ALLISHA
Middle Name:NICOLE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ALLISHA
Other - Middle Name:NICOLE
Other - Last Name:GAGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:36 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1150
Mailing Address - Country:US
Mailing Address - Phone:631-878-1371
Mailing Address - Fax:
Practice Address - Street 1:36 MILLER AVE
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940-1150
Practice Address - Country:US
Practice Address - Phone:631-878-1371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587496-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse