Provider Demographics
NPI:1528050200
Name:HUFNAGEL, RICHARD G JR (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:HUFNAGEL
Suffix:JR
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 1:91 FORT COUCH RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1033
Mailing Address - Country:US
Mailing Address - Phone:412-835-7001
Mailing Address - Fax:
Practice Address - Street 1:91 FORT COUCH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1033
Practice Address - Country:US
Practice Address - Phone:412-835-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007381L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU74061OtherUPIN
PA001737077Medicaid
PA218904OtherUPMC
PA987253OtherBCBS RENDERING PROVIDER
PA577689OtherPA BLUE SHIELD -- GROUP
PA251879312OtherCOMMERICAL PAYORS
PAU74061OtherUPIN