Healthcare Provider Details

I. General information

NPI: 1568064392
Provider Name (Legal Business Name): JAMES RONAYNE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9048 SUGAR EST
ST THOMAS VI
00802-3634
US

IV. Provider business mailing address

PO BOX 600330
ST THOMAS VI
00801-6330
US

V. Phone/Fax

Practice location:
  • Phone: 914-602-1868
  • Fax:
Mailing address:
  • Phone: 914-602-1868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES PATRICK RONAYNE
Title or Position: OWNER
Credential: MD
Phone: 914-602-1868