Provider Demographics
NPI:1437944238
Name:RICHARDS, SEAN MATTHEW
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MATTHEW
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BLOOMFIELD AVE APT 191
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9925
Mailing Address - Country:US
Mailing Address - Phone:516-404-1089
Mailing Address - Fax:
Practice Address - Street 1:85 BLOOMFIELD AVE APT 191
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9925
Practice Address - Country:US
Practice Address - Phone:516-404-1089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program