Individual
PETER RONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 MITCHELL AVE, NEW HORIZONS, BINGHAMTON, NY 13903
(607) 762-2255
Mailing address
58 LUSK ST, JOHNSON CITY, NY 13790-2541
(607) 763-6293
(607) 763-6717
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
154048
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00899725
—
NY
Enumeration date
05/01/2006
Last updated
08/05/2010
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