Individual
DR. JON JOSEPH RANDAZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
10515 LIBERTY AVE, OZONE PARK, NY 11417-1809
(718) 843-7720
Mailing address
PO BOX 70160, STATEN ISLAND, NY 10307-0160
(718) 843-7720
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X007603-1
NY
Other
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
Enumeration date
06/06/2007
Last updated
10/06/2011
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