Provider Demographics
NPI:1235219023
Name:DINAPOLI, RICHARD (OPHTHALMIC DISPENSER)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:DINAPOLI
Suffix:
Gender:M
Credentials:OPHTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3723
Mailing Address - Country:US
Mailing Address - Phone:845-561-2970
Mailing Address - Fax:
Practice Address - Street 1:313 FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3723
Practice Address - Country:US
Practice Address - Phone:845-561-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY4533156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1306760001Medicare ID - Type Unspecified