Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X004836-1 | NY |
NPI | 1710069398 |
---|---|
Provider Name | Dr. Richard A Dark |
First Address | Farmingville, NY 11738-2107 |
Second Address | Farmingville, NY 11738-2107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017091 | GHI (01) | NY |
11-2946756 | LANDMARK (01) | CA |
115137 | MPN (01) | NY |
1280677 | UNITED HEALTH CARE (01) | NY |
320250 | AMERICAN SPECIALTY HEALTH (01) | CA |
76833 | AETNA (01) | NY |
8983718-00 | CIGNA (01) | CT |
P647932 | OXFORD (01) | NY |
T89855 | (02) |