Healthcare Provider Details

I. General information

NPI: 1619917325
Provider Name (Legal Business Name): RONALD H. ISRAELSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RYKOWSKI LN
MIDDLETOWN NY
10941-4019
US

IV. Provider business mailing address

30 HATFIELD LN SUITE 201
GOSHEN NY
10924-6766
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-6224
  • Fax: 845-692-7408
Mailing address:
  • Phone: 845-294-3446
  • Fax: 845-294-4171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number182146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: