Provider Demographics
NPI:1134187578
Name:RICHARDS, JANUSZ R (DC)
Entity type:Individual
Prefix:
First Name:JANUSZ
Middle Name:R
Last Name:RICHARDS
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 1:150 PURCHASE ST.
Mailing Address - Street 2:SUITE 5
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2141
Mailing Address - Country:US
Mailing Address - Phone:914-967-5655
Mailing Address - Fax:914-967-5887
Practice Address - Street 1:150 PURCHASE ST
Practice Address - Street 2:SUITE 5
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2141
Practice Address - Country:US
Practice Address - Phone:914-967-5655
Practice Address - Fax:914-967-5887
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-003534-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01819158Medicaid
NYX20011Medicare ID - Type UnspecifiedEMPIRE BLUE CROSS BLUE SH
NY01819158Medicaid