Provider Demographics
NPI:1275695975
Name:NEBIOSINI, RICHARD A (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:NEBIOSINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 ROUTE 25A
Mailing Address - Street 2:UNIT 9
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2500
Mailing Address - Country:US
Mailing Address - Phone:631-752-4000
Mailing Address - Fax:
Practice Address - Street 1:451 ROUTE 25A
Practice Address - Street 2:UNIT 9
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2500
Practice Address - Country:US
Practice Address - Phone:631-752-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00182186OtherMEDICARE RAILROAD
NYX26751Medicare ID - Type Unspecified
P00182186OtherMEDICARE RAILROAD