Provider Demographics
NPI:1508949702
Name:BIONDI, RICHARD P (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:BIONDI
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 1:875 MAMARONECK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1976
Mailing Address - Country:US
Mailing Address - Phone:914-381-7575
Mailing Address - Fax:877-900-5184
Practice Address - Street 1:875 MAMARONECK AVE STE 102
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1976
Practice Address - Country:US
Practice Address - Phone:914-381-7575
Practice Address - Fax:877-900-5184
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009056-1111NN1001X, 111NS0005X
NYX0090561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX5B061Medicare PIN
NYU73540Medicare UPIN