Siahaan, Richard
Siahaan, Richard is an individual health care provider with primary practice located at 421 Cottage Grove Rd , Bloomfield CT 06002-3170. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Siahaan, Richard can be contacted via phone (860) 242-0034.Contact Information
Primary practice address
421 Cottage Grove Rd
Bloomfield CT 06002-3170
Phone: (860) 242-0034
Fax: (860) 242-3301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24303 | Connecticut |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 024303 | Connecticut |
Profile Details
| NPI number | 1013133628 |
|---|---|
| LBN Legal business name | Siahaan, Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2007 |
| Last updated | Dec 28th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013133628 | NPPES |
| Connecticut | Other | 004263612 | CHN |
| Connecticut | Other | 0V0438 | CHN |
| Connecticut | Other | 7294618 | CHN |
| Connecticut | Other | 704554 | CHN |
| Connecticut | MEDICAID | 004263612 | CHN |
| Connecticut | Other | 369877 | CHN |
| Connecticut | Other | 427750 | CHN |
| Connecticut | Other | 80705 | CHN |
| Connecticut | Other | 010024303CT01 | CHN |
| Connecticut | Other | 514837 | CHN |
| Connecticut | Other | P3592661 | CHN |
| Connecticut | Other | 1751515 | CHN |
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