Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N0029341 | NY |
Y | 222Z00000X | Podiatrist | N0029341 | NY |
NPI | 1023069044 |
---|---|
Provider Name | Dr. Ronald S D'amico |
First Address | Liverpool, NY 13090-3538 |
Second Address | Liverpool, NY 13090-3538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 10/06/2013 |