Healthcare Provider Details

I. General information

NPI: 1225323298
Provider Name (Legal Business Name): DR RONNA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 E MAIN ST
LITTLE FALLS NJ
07424-5609
US

IV. Provider business mailing address

96 E MAIN ST
LITTLE FALLS NJ
07424-5609
US

V. Phone/Fax

Practice location:
  • Phone: 973-256-2166
  • Fax:
Mailing address:
  • Phone: 973-256-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRI RONNA
Title or Position: OWNER
Credential: DPM
Phone: 201-707-5110