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General NPI Number Information
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NPI Number | 1134331010
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Entity Type | Organization
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Legal Business Name | RONALD M. NUGGET D.C.,P.C.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 224 MARK TREE RD
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City | CENTEREACH
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State | NY
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Zip | 11720-2278
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Country | US
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Telephone | 631-981-4333
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Fax | 631-981-4019
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Provider Business Mailing Address
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Address Line | 224 MARK TREE RD
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City | CENTEREACH
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State | NY
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Zip | 11720-2278
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Country | US
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Telephone | 631-981-4333
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Fax | 631-981-4019
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RONALD MARVIN NUGGET
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Credential | DC
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Telephone | 631-981-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X1803
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License Number State | NY
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