Formica, Richard Nicholas

Formica, Richard Nicholas is an individual health care provider with primary practice located at 800 Howard Ave Yale Physicians Building, New Haven CT 06519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Formica, Richard Nicholas can be contacted via phone (203) 785-2140.

Contact Information

Primary practice address
800 Howard Ave Yale Physicians Building New Haven CT 06519
Phone: (203) 785-2140
Fax: (203) 785-6414
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036848 Connecticut
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036848 Connecticut

Profile Details

NPI number 1730163502
LBN Legal business name Formica, Richard Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Mar 22nd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730163502 NPPES
Connecticut MEDICAID 001368481

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