Carlson Jr, Richard Andrew

Carlson Jr, Richard Andrew is an individual health care provider with primary practice located at 1491 Sheridan Dr Sheridan Medical Group, Tonawanda NY 14217-1234. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Carlson Jr, Richard Andrew can be contacted via phone (716) 332-4476.

Contact Information

Primary practice address
1491 Sheridan Dr Sheridan Medical Group Tonawanda NY 14217-1234
Phone: (716) 332-4476
Fax: (716) 332-4479
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 183745 New York
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 183745 New York

Profile Details

NPI number 1740246735
LBN Legal business name Carlson Jr, Richard Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jan 25th, 2013 - 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 1740246735 NPPES
New York MEDICAID 01226122

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