Provider Demographics
NPI:1396884938
Name:ARAYA, J RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:J RICHARD
Middle Name:
Last Name:ARAYA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:RICHARD
Other - Last Name:ARAYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:39 TALCOTT RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1227
Mailing Address - Country:US
Mailing Address - Phone:860-561-5433
Mailing Address - Fax:860-561-2754
Practice Address - Street 1:39 TALCOTT RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1227
Practice Address - Country:US
Practice Address - Phone:860-561-5433
Practice Address - Fax:860-561-2754
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT 01377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU83884Medicare UPIN