Individual
DR. RONALD GENE NATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009408
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000490288004
BLUE SHIELD
NY
05
—
01382769
—
NY
01
—
058011
CDPHP PROVIDER NUMBER
NY
01
—
41300
MVP PROVIDER NUMBER
NY
01
—
6894417
GHI PROVIDER NUMBER
NY
Enumeration date
12/04/2006
Last updated
07/09/2007
Update your record
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