Provider Demographics
NPI:1386713246
Name:SEARS, RICHARD CARROLL JR (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CARROLL
Last Name:SEARS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9 GREGORY WAY
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-1137
Mailing Address - Country:US
Mailing Address - Phone:631-369-9218
Mailing Address - Fax:631-369-0988
Practice Address - Street 1:9 GREGORY WAY
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-1137
Practice Address - Country:US
Practice Address - Phone:631-369-9218
Practice Address - Fax:631-369-0988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor