Healthcare Provider Details

I. General information

NPI: 1487893293
Provider Name (Legal Business Name): ZECHARIAH RIVIETZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 E 74TH ST APT 1C
NEW YORK NY
10021-3208
US

IV. Provider business mailing address

173 E 74TH ST APT 1C
NEW YORK NY
10021-3208
US

V. Phone/Fax

Practice location:
  • Phone: 516-480-2936
  • Fax: 631-231-5201
Mailing address:
  • Phone: 516-480-2936
  • Fax: 631-231-5201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCH6846
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberX009571-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: