Provider Demographics
NPI:1376628750
Name:FINK, RICHARD M (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:FINK
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 1:667 LARKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:E NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5912
Mailing Address - Country:US
Mailing Address - Phone:631-462-6330
Mailing Address - Fax:631-462-6331
Practice Address - Street 1:667 LARKFIELD RD
Practice Address - Street 2:
Practice Address - City:E NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-5912
Practice Address - Country:US
Practice Address - Phone:631-462-6330
Practice Address - Fax:631-462-6331
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX18101Medicare ID - Type Unspecified