MEDICARE: DR. RONALD ST LOUIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	173155	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39K682	OTHER	NY	BC BS PROVIDER NUMBER
2	432899N1	OTHER	NY	CIGNA PROVIDER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1782397	OTHER	NY	UNITED HEALTHCARE
5	0H2808	OTHER	NY	HEALTHNET PROVIDER NUMBER
6	7886075	OTHER	NY	AETNA PPO
7	3208825	OTHER	NY	AETNA-HMO PROVIDER NUMBER
8	13406262101	OTHER	NY	1199 NAT'L BENEFIT FUND
9	P2486790	OTHER	NY	OXFORD PROVIDER NUMBER
10	0401897	OTHER	NY	UNITED HEALTHCARE MEDICAR
11	173155-C14	OTHER	NY	HEALTHFIRST PROVIDER #

General Provider Information

NPI Number	:	1336153303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD ST LOUIS MD

Provider Business Mailing Address
First Line	:	1333A NORTH AVE
Second Line	:	P.M.B.709
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10804-2120
Country	:	US
Telephone Number	:	718-324-6365
Fax Number	:	718-881-5700

Provider Business Practice Location Address
First Line	:	3327 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2801
Country	:	US
Telephone Number	:	718-324-6365
Fax Number	:	718-881-5700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	05/19/2022

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