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General NPI Number Information
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NPI Number | 1306399555
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Entity Type | Organization
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Legal Business Name | RICHMOND CHIROPRACTIC CARE, PC
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Dates
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Enumeration Date | 07/24/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 2052 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2583
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Country | US
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Telephone | 732-617-8000
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Fax | 732-591-1000
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Provider Business Mailing Address
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Address Line | 436 ROUTE 79
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City | MORGANVILLE
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State | NJ
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Zip | 07751-9783
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Country | US
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Telephone | 732-617-8000
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Fax | 732-591-1000
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL A CARDUCCI
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Credential | DC
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Telephone | 732-617-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X0106333
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License Number State | NY
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