MEDICARE: MR. RONALD DINGWELL NP

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	363LF0000X	Family Nurse Practitioner	F333307	NY

General Provider Information

NPI Number	:	1619080249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD DINGWELL NP

Provider Business Mailing Address
First Line	:	734 FRANKLIN AVE
Second Line	:	# 463
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-4525
Country	:	US
Telephone Number	:	516-495-0174
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 HEMPSTEAD TPKE
Second Line	:	BROOKDALE UNIV HOSPITAL & MEDICAL CENTER
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-2155
Country	:	US
Telephone Number	:	516-493-9580
Fax Number	:	516-493-9581

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	01/13/2017

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