Provider Demographics
NPI:1639225865
Name:NUNZIATA, RICHARD F (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:NUNZIATA
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 1:2813 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-934-0554
Mailing Address - Fax:718-934-0481
Practice Address - Street 1:2813 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3158
Practice Address - Country:US
Practice Address - Phone:718-934-0554
Practice Address - Fax:718-934-0481
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T52586Medicare UPIN
X21281Medicare ID - Type Unspecified