MR. Richard Thailer, PA-C

NPI #1023651643 in East Northport, New York

Provider Information

NPI Number: 1023651643
Entity Type: Individual
Name: MR. Richard Thailer, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 27, 2019
Last Updated: Oct 27, 2019

Practice Location

Address: 19 MANSFIELD LN S
City: East Northport
State: New York
ZIP Code: 11731-4134
Phone: (631) 334-0627

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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