Provider Demographics
NPI:1457417206
Name:BOVE, RICHARD ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:BOVE
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 1:7378 AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1450
Mailing Address - Country:US
Mailing Address - Phone:718-948-9598
Mailing Address - Fax:718-605-2992
Practice Address - Street 1:7378 AMBOY RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1450
Practice Address - Country:US
Practice Address - Phone:718-948-9598
Practice Address - Fax:718-605-2992
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007515-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00296886OtherRAILROAD MEDICARE INDIVID
5803469OtherGHI
P2486119OtherOXFORD
2560341OtherAETNA
X8M17OtherEMPIRE HEALTH PLANS
NY102840400OtherACN
179023OtherELDERPLAN
827593OtherMPN
DE5018OtherRAILROAD MEDICARE GROUP
X8M17OtherEMPIRE HEALTH PLANS
NYXLW231Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER