Provider Demographics
NPI:1073682365
Name:LAWSON, RICHARD A (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:LAWSON
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:PO BOX 17
Mailing Address - Street 2:5701 BERKSHIRE VALLEY RD
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-0017
Mailing Address - Country:US
Mailing Address - Phone:973-697-6727
Mailing Address - Fax:973-764-2889
Practice Address - Street 1:5701 BERKSHIRE VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07438-9860
Practice Address - Country:US
Practice Address - Phone:973-697-6727
Practice Address - Fax:973-764-2889
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC2566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ441589Medicare ID - Type Unspecified