Provider Demographics
NPI:1447223813
Name:BOWLES, RAYMOND E (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:E
Last Name:BOWLES
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 1:998 CARMANS RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3505
Mailing Address - Country:US
Mailing Address - Phone:516-541-4730
Mailing Address - Fax:516-541-4748
Practice Address - Street 1:998 CARMANS RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3505
Practice Address - Country:US
Practice Address - Phone:516-541-4730
Practice Address - Fax:516-541-4748
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0071971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU65227Medicare UPIN
NYX02051Medicare ID - Type Unspecified