Provider Demographics
NPI:1841276813
Name:JANOF, RICHARD M (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:JANOF
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 1:83 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2740
Mailing Address - Country:US
Mailing Address - Phone:917-826-4402
Mailing Address - Fax:
Practice Address - Street 1:83 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2740
Practice Address - Country:US
Practice Address - Phone:917-826-4402
Practice Address - Fax:917-826-4402
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX58431Medicare PIN
NYT52834Medicare UPIN