# DR. JON JOSEPH RANDAZZO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1639372022
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X007603-1 | NY | Yes |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 10/06/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 20-3202120 | NATIONAL HEALTH PLAN | NY |
| 01 | — | 5897310 | GHI, GROUP HEALTH INC. \# | NY |
| 01 | — | CO 7603-1 | NEW YORK WORKERS COMP | NY |
| 01 | — | P41-5011 | OXFORD | NY |