DR. DEREK PROCTOR RICHARDSON (NPI# 1568552719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568552719 |
| Entity Type | Individual |
| Full Name | DR. DEREK PROCTOR RICHARDSON |
| Credential | MD |
| Practice Address |
Four Irongate Center Glens Falls NY 12801 |
| Practice Telephone | 5187981778 |
| Practice Fax Number | 5187981846 |
| Mailing Telephone | 5187981778 |
| Mailing Fax Number | 5187981846 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 114475 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | CDPHP | 10001709 | 01 |
| NY | 00352149 | 05 | |
| NY | MVP HEALTH PLAN | 07121 | 01 |
| NY | BLUE CROSS | 48F2111 | 01 |
| NY | FIDELIS | 040426007626 | 01 |
| NY | BLUE SHIELD | 000407083001 | 01 |
| TAX ID # | 141622071 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215194790 | Derek W Richardson | Physical Therapy Assistant | 302 Hancock St, Holdrege, NE 68949-2741 | 2008-05-21 |
| 1871750851 | Derek Kuhl Richardson | Emergency Medicine | 1689 Turk St, San Francisco, CA 94115-4527 | 2008-05-19 |
| 1245247006 | Derek Keith Richardson | Psychiatry & Neurology | 200 Crescent Centre Parkway, Kaiser Permanente Crescent Centre Medical Center, Tucker, GA 30084 | 2006-08-02 |
| 1477809697 | Derek Alexander Richardson | Optometrist | 10000 Bay Pines Blvd, Bay Pines, FL 33744 | 2012-07-25 |
| 1205061553 | Derek M Richardson | Family Medicine | 315 W 2nd St, Greenville, NC 27834-1969 | 2009-05-15 |
| Street Address |
FOUR IRONGATE CENTER |
| City | GLENS FALLS |
| State | NY |
| Zip Code | 12801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629549399 | Upstate Vision Care, Pllc | Technician/Technologist | 206 Glen St. Suite 31b, Colvin Building, Glens Falls, NY 12801 | 2018-12-06 |
| 1043737356 | Tiffany Britt | Social Worker | 43 Kensington Rd, Glens Falls, NY 12801 | 2017-08-28 |
| 1922375922 | Kathleen A Callaghan | Registered Nurse | 43 Kensington Road, Glens Falls, NY 12801 | 2011-11-19 |
| 1043595531 | Nancy K. Carroll | Social Worker | 37 Broad St., Glens Falls, NY 12801 | 2011-10-15 |
| 1992027528 | Benjamin Alan Rametta | Pharmacist | 202 Broad Street, Walgreens, Glens Falls, NY 12801 | 2010-02-23 |
| 1194052563 | Angela M Lalla | Audiologist | 318 Ridge Street, Glens Sallas, NY 12801 | 2009-11-05 |
| 1407018591 | Marilyn J Bryan | Counselor | 4 Technical Park, Suite #3, #6, Glens Falls, NY 12801 | 2008-06-30 |
| 1104087667 | Chase Chiropractic LLC | Chiropractor | 17 Pine St. 1 Irongate Center, Suite 3, Glens Falls, NY 12801 | 2008-06-18 |
| 1619183571 | Glens Falls Crossings LLC | Skilled Nursing Facility | 170 Warren Street, Glens Falls, NY 12801 | 2007-05-15 |
| 1417099706 | Patricia Ann Cameron | Psychologist | 464 Glen Street, Glens Falls, NY 12801 | 2007-02-13 |
| Find all providers in zip 12801 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407156193 | Derek P Richardson,md,pc | Dermatology | 4 Irongate Ctr, Glens Falls, NY 12801-3471 | 2010-10-27 |
| 1821119124 | Stephen Charles Verral | Dermatology | 1 S Western Ave, Glens Falls, NY 12801-3304 | 2007-04-03 |
| 1598020273 | Tess Helen Pollinger | Dermatology | 1 S Western Ave, Glens Falls, NY 12801-3309 | 2012-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225636384 | Markowitz Medical Pllc | Dermatology | 1150 5th Ave # Suire1a, New York, NY 10128-0724 | 2020-10-12 |
| 1114545985 | Tarek Yamany Md Pllc | Dermatology | 229 W 60th St Apt 8e, New York, NY 10023-7507 | 2020-07-08 |
| 1952924839 | Elizabeth Jessica Ranelli | Dermatology | 16 W 17th St, New York, NY 10011-5738 | 2020-05-26 |
| 1841811148 | Stuart Daniel Shanler | Dermatology | 53 Underhill Dr, Pomona, NY 10970-2668 | 2020-04-28 |
| 1740800309 | Ns Arora Dermatology Pllc | Dermatology | 99 Jericho Tpke Ste 110, Jericho, NY 11753-1015 | 2020-04-23 |
| 1174163406 | Halite Services Crop | Dermatology | 447 Rose Ln, Rockville Centre, NY 11570-1429 | 2020-01-15 |
| 1235776485 | Libby Rhee Do Dermatology Pllc | Dermatology | 110 E 60th St # 800, New York, NY 10022-1688 | 2019-12-06 |
| 1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
| 1568018588 | Mary Matina Valinotti | Dermatology | 332 E Main St Ste 1, Bay Shore, NY 11706-8436 | 2019-08-15 |
| 1831751379 | Jessica Weiser, M.d., Pllc | Dermatology | 155 Spring St Fl 5, New York, NY 10012-5208 | 2019-07-05 |
| Find all providers with the same taxonomy | ||||
| City | GLENS FALLS |
| Zip Code | 12801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.