Provider Demographics
NPI:1477525137
Name:RIKER, JEFFREY P (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:RIKER
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 1:398 FEURA BUSH RD
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077
Mailing Address - Country:US
Mailing Address - Phone:518-449-3071
Mailing Address - Fax:518-449-3073
Practice Address - Street 1:398 FEURA BUSH RD
Practice Address - Street 2:
Practice Address - City:GLENMONT
Practice Address - State:NY
Practice Address - Zip Code:12077
Practice Address - Country:US
Practice Address - Phone:518-449-3071
Practice Address - Fax:518-449-3073
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX7718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T32187Medicare UPIN
DD6537Medicare ID - Type Unspecified