Wayne, Richard R

Wayne, Richard R is an individual health care provider with primary practice located at 961 Canal St , Syracuse NY 13210-1203. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Wayne, Richard R can be contacted via phone (315) 478-1977.

Contact Information

Primary practice address
961 Canal St Syracuse NY 13210-1203
Phone: (315) 478-1977
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 208466 New York

Profile Details

NPI number 1720081771
LBN Legal business name Wayne, Richard R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Mar 25th, 2010 - about 14 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 1720081771 NPPES
New York MEDICAID 02172030
New York Other 208466-3B

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