Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 042183 | NY |
NPI | 1114189479 |
---|---|
Provider Name | Dr. Ronald Louis Biondo |
First Address | New York, NY 10016-1201 |
Second Address | New York, NY 10016-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 27/06/2008 |