Healthcare Provider Details

I. General information

NPI: 1730192535
Provider Name (Legal Business Name): EUGENE RINALDI DEMINICO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 S MAIN ST
PITTSTON PA
18640-1713
US

IV. Provider business mailing address

84 S MAIN ST
PITTSTON PA
18640-1713
US

V. Phone/Fax

Practice location:
  • Phone: 570-654-0036
  • Fax: 570-654-7890
Mailing address:
  • Phone: 570-654-0036
  • Fax: 570-654-7890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC001908L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: