Provider Demographics
NPI:1114225638
Name:RAYMOND A. SEMENTE D.C., P.C.
Entity Type:Organization
Organization Name:RAYMOND A. SEMENTE D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEMENTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-584-7722
Mailing Address - Street 1:265 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2221
Mailing Address - Country:US
Mailing Address - Phone:631-584-7722
Mailing Address - Fax:631-584-7722
Practice Address - Street 1:265 LAKE AVE
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2221
Practice Address - Country:US
Practice Address - Phone:631-584-7722
Practice Address - Fax:631-584-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3508-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01738352Medicaid
NYX21361Medicare PIN