Provider Demographics
NPI:1700956570
Name:SAUNDERS, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WILLOWBROOK ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804
Mailing Address - Country:US
Mailing Address - Phone:518-793-9156
Mailing Address - Fax:518-793-6591
Practice Address - Street 1:25 WILLOWBROOK ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804
Practice Address - Country:US
Practice Address - Phone:518-793-9156
Practice Address - Fax:518-793-6591
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY181379207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01211201Medicaid
NYAA0798Medicare PIN
E62903Medicare UPIN
NY01211201Medicaid