Provider Demographics
NPI:1487617775
Name:NETSKY, RICHARD IRVING (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRVING
Last Name:NETSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12 BURNLEY RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-1103
Mailing Address - Country:US
Mailing Address - Phone:671-365-2047
Mailing Address - Fax:781-740-0233
Practice Address - Street 1:175 DERBY ST STE 7
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4021
Practice Address - Country:US
Practice Address - Phone:617-876-4099
Practice Address - Fax:781-740-0233
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-09
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA412142084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0195588Medicaid
MA0195588Medicaid