Provider Demographics
NPI:1568592988
Name:STATLER, RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:STATLER
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:RICHARD STATLER, J.C.
Mailing Address - Street 2:829 EAST JERICHO TPKE
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746
Mailing Address - Country:US
Mailing Address - Phone:631-424-2225
Mailing Address - Fax:631-385-8484
Practice Address - Street 1:RICHARD STATLER, J.C.
Practice Address - Street 2:829 EAST JERICHO TPKE
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:631-424-2225
Practice Address - Fax:631-385-8484
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX04189-9111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor