Provider Demographics
NPI:1316921661
Name:SEIBERT, RICHARD EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EDWARD
Last Name:SEIBERT
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 1:1991 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3145
Mailing Address - Country:US
Mailing Address - Phone:516-867-8585
Mailing Address - Fax:516-867-1505
Practice Address - Street 1:1991 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3145
Practice Address - Country:US
Practice Address - Phone:516-867-8585
Practice Address - Fax:516-867-1505
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005003111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
0014576OtherGHI
563471OtherUNITED HEALTH CARE
8842419-003OtherCIGNA
4304653OtherAETNA
P2752005OtherOXFORD
4304653OtherAETNA
563471OtherUNITED HEALTH CARE