Provider Demographics
NPI:1134252323
Name:AMATO, RICHARD EDWARD (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWARD
Last Name:AMATO
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 1:6133 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2739
Mailing Address - Country:US
Mailing Address - Phone:718-429-6630
Mailing Address - Fax:718-429-6584
Practice Address - Street 1:6133 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2739
Practice Address - Country:US
Practice Address - Phone:718-429-6630
Practice Address - Fax:718-429-6584
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX00-7091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5897444OtherGHI
NYX8K69OtherBCBSPPO/EPO
NY5278428OtherAETNA
NYCO7091-4BOtherWORKERS COMP
NYP1943342OtherOXFORD
NY5897444OtherGHI