Provider Demographics
NPI:1891736500
Name:DUENAS, RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:DUENAS
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 1:557 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-523-5833
Mailing Address - Fax:860-523-7407
Practice Address - Street 1:557 PROSPECT AVE
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2922
Practice Address - Country:US
Practice Address - Phone:860-523-5833
Practice Address - Fax:860-523-7407
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T52764Medicare UPIN
350000983Medicare ID - Type Unspecified