Healthcare Provider Details

I. General information

NPI: 1881671972
Provider Name (Legal Business Name): RICHARD C. MEOLI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 MERRICK AVE
EAST MEADOW NY
11554-3740
US

IV. Provider business mailing address

595 MERRICK AVE
EAST MEADOW NY
11554-3740
US

V. Phone/Fax

Practice location:
  • Phone: 516-481-1400
  • Fax: 516-481-1411
Mailing address:
  • Phone: 516-481-1400
  • Fax: 516-481-1411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX-004171
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: