Healthcare Provider Details

I. General information

NPI: 1104877653
Provider Name (Legal Business Name): RICHARD SAPORITO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 STAFFORD AVE
BRISTOL CT
06010-4616
US

IV. Provider business mailing address

PO BOX 262 655 TERRYVILLE AVENUE
BRISTOL CT
06011-0262
US

V. Phone/Fax

Practice location:
  • Phone: 860-589-1491
  • Fax:
Mailing address:
  • Phone: 860-589-1491
  • Fax: 860-583-3581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number000445
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: