Richard K Bokoth I

Individual provider Active NPI Community/Behavioral Health Agency · Adelphi, MD

NPI 1407550262 · NPPES record last updated Mar 27, 2023

Key facts

NPI
1407550262
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
1836 Metzerott Rd Apt 1727
Adelphi, MD 20783-3452
Phone
(204) 704-2765
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

1836 Metzerott Rd Apt 1727
Adelphi, MD 20783-3452

Mailing address

1836 Metzerott Rd Apt 1727
Adelphi, MD 20783-3452
Phone (240) 704-2765

Other providers in Adelphi, MD

All providers in Adelphi, MD · Community/Behavioral Health Agency in Maryland

Sources for this page

Verify at the official NPI Registry.