Provider Demographics
NPI:1295304228
Name:RICHMAN, CHANA (OD)
Entity type:Individual
Prefix:DR
First Name:CHANA
Middle Name:
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHANA
Other - Middle Name:
Other - Last Name:RICHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHANA HAIMOWITZ
Mailing Address - Street 1:1863 59TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2318
Mailing Address - Country:US
Mailing Address - Phone:347-517-3415
Mailing Address - Fax:
Practice Address - Street 1:5597 TULIP ST STE B8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1562
Practice Address - Country:US
Practice Address - Phone:267-360-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-23
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009344152W00000X
PAOEG004099152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist