Provider Demographics
NPI:1689790198
Name:RIOTTO, ANTHONY M (DC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:M
Last Name:RIOTTO
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 1:128 KINDERKAMACK ROAD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656
Mailing Address - Country:US
Mailing Address - Phone:201-505-9700
Mailing Address - Fax:201-505-9701
Practice Address - Street 1:128 KINDERKAMACK ROAD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656
Practice Address - Country:US
Practice Address - Phone:201-505-9700
Practice Address - Fax:201-505-9701
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00584500111N00000X
NYX009631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8982007Medicaid
NJ8982007Medicaid
NJ054977Medicare ID - Type Unspecified