Provider Demographics
NPI:1124102157
Name:MOLINARI, RICHARD RALPH (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RALPH
Last Name:MOLINARI
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 1:149 PARK RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1731
Mailing Address - Country:US
Mailing Address - Phone:973-292-4960
Mailing Address - Fax:973-292-1065
Practice Address - Street 1:149 PARK RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1731
Practice Address - Country:US
Practice Address - Phone:973-292-4960
Practice Address - Fax:973-292-1065
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00246000111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ450006Medicare ID - Type Unspecified