Individual
MR. RONALD DALE KLIZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 S MAIN ST STE 250, JAMESTOWN, NY 14701-6627
(716) 664-9731
(716) 664-9160
Mailing address
15 S MAIN ST STE 250, P O BOX 788, JAMESTOWN, NY 14701-6627
(716) 664-9731
(716) 664-9160
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
144625
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00706643
—
NY
01
—
144625
WORKERS COMPENSATION
NY
01
—
300016615
RAILROAD MEDICARE
NY
Enumeration date
10/05/2005
Last updated
12/12/2013
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