Individual
RONALD JOSEPH IANNACONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2640 HIGHWAY 70, BLDG 6B, MANASQUAN, NJ 08736
(732) 223-8686
(732) 223-6572
Mailing address
2640 HIGHWAY 70, BLDG 6B, MANASQUAN, NJ 08736-2609
(732) 223-8686
(732) 223-6572
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
MB55529
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6217401
—
NJ
Enumeration date
12/09/2005
Last updated
11/14/2012
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