Healthcare Provider Details

I. General information

NPI: 1659384014
Provider Name (Legal Business Name): RONALD BRUCE LINCOW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 RIDGEWOOD RD STE 200
WYOMISSING PA
19610-1196
US

IV. Provider business mailing address

1705 SOMERSET ST
DRESHER PA
19025-1312
US

V. Phone/Fax

Practice location:
  • Phone: 610-375-6226
  • Fax: 484-509-2933
Mailing address:
  • Phone: 215-338-1811
  • Fax: 215-338-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS013632
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOS013632
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: