Provider Demographics
NPI:1710104856
Name:JAVARONE, RICHARD J (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:JAVARONE
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 1:105 SEMINARY AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-9747
Mailing Address - Country:US
Mailing Address - Phone:724-693-8226
Mailing Address - Fax:724-693-8236
Practice Address - Street 1:105 SEMINARY AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:OAKDALE
Practice Address - State:PA
Practice Address - Zip Code:15071-9747
Practice Address - Country:US
Practice Address - Phone:724-693-8226
Practice Address - Fax:724-693-8236
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-005365-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAJA589854OtherBLUE CROSS BLUE SHIELD NU