Individual
MICHAEL R RONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN FNP, RNFA
Contact information
Practice address
10 BRENTWOOD DR, SUITE B, ITHACA, NY 14850-1865
(607) 266-0073
(607) 266-9310
Mailing address
10 BRENTWOOD DR, SUITE B, ITHACA, NY 14850-1865
(607) 266-0073
(607) 266-9310
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
331855
NY
363L00000X
Nurse Practitioner
F331855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02266791
—
NY
Enumeration date
07/27/2006
Last updated
12/29/2008
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