Provider Demographics
NPI:1477646867
Name:MANONI, RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MANONI
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 1:465 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3901
Mailing Address - Country:US
Mailing Address - Phone:516-939-0066
Mailing Address - Fax:516-681-0405
Practice Address - Street 1:465 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3901
Practice Address - Country:US
Practice Address - Phone:516-939-0066
Practice Address - Fax:516-681-0405
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0023801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X13671Medicare ID - Type Unspecified