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Contact Information

RICHARD N CHANNICK, MD
55 FRUIT ST
COX 2
BOSTON, MA02114-2621
 Phone: 617-724-3705
 Fax: 617-724-6954
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for RICHARD N CHANNICK · (Male)

NPI # 1144255886
Status Active
Credentials MD
Entity Individual
Enumeration date 07/11/2006
Last updated 02/28/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 56347
  • CA Medicaid 00G626950
  • MA Medicaid 110004417/A
Hospital affiliation(s)
  • RONALD REAGAN UCLA MEDICAL CENTER - (Acute Care)
    757 WESTWOOD PLAZA
    LOS ANGELES, CA 90095
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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