Healthcare Provider Details

I. General information

NPI: 1619881877
Provider Name (Legal Business Name): ROBERT RAGONA RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEROES WAY
RIVERHEAD NY
11901-2058
US

IV. Provider business mailing address

1 HEROES WAY
RIVERHEAD NY
11901-2058
US

V. Phone/Fax

Practice location:
  • Phone: 631-548-6883
  • Fax: 631-548-6422
Mailing address:
  • Phone: 631-548-6883
  • Fax: 631-548-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number738456
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: