Provider Demographics
NPI:1881671972
Name:MEOLI, RICHARD C (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:MEOLI
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 1:595 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3740
Mailing Address - Country:US
Mailing Address - Phone:516-481-1400
Mailing Address - Fax:516-481-1411
Practice Address - Street 1:595 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3740
Practice Address - Country:US
Practice Address - Phone:516-481-1400
Practice Address - Fax:516-481-1411
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-004171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P1606744OtherOXFORD HEALTH PLANS
4C0498OtherLANDMARK HEALTHCARE
6710998-004OtherCIGNA HEALTH PLANS
NY113137037-01OtherHIP
NJ2078685OtherAETNA HEALTH PLANS
487982OtherUNITED HEALTHCARE
NYC04171-7OtherWORKERS' COMPENSATION
NYX2281OtherEMPIRE BC/BS
0036934OtherGROUP HEALTH INSURANCE
20183OtherVYTRA HEALTH PLANS
NJ2078685OtherAETNA HEALTH PLANS
NYX-22811Medicare PIN
NYU34250Medicare UPIN