Thackston, Richard

Thackston, Richard is an individual health care provider with primary practice located at 515 Moe Rd , Clifton Park NY 12065-3821. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Thackston, Richard can be contacted via phone (518) 280-4294.

Contact Information

Primary practice address
515 Moe Rd Clifton Park NY 12065-3821
Phone: (518) 280-4294
Fax: (518) 280-4297
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X New York

Profile Details

NPI number 1255700290
LBN Legal business name Thackston, Richard
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2015
Last updated Sep 21st, 2015 - about 11 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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