Basic Information
Provider Information
NPI: 1306196605
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAMBURY
FirstName: RICHARD
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1275 YORK AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100656007
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 353 E 68TH ST
Address2: SIDNEY KIMMEL CENTER FOR PROSTATE AND UROLOGIC CANCERS
City: NEW YORK
State: NY
PostalCode: 100655606
CountryCode: US
TelephoneNumber: 2126392000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/13/2012
LastUpdateDate: 08/20/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X275123NYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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