Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 004104 | NY |
Y | 222Z00000X | Podiatrist | 004104 | NY |
NPI | 1013980994 |
---|---|
Provider Name | Dr. Ronald F Iannacone |
First Address | Brooklyn, NY 11234-6129 |
Second Address | Brooklyn, NY 11234-6129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 11/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01020057 | (05) | NY |
T31877 | (02) | NY |