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General NPI Number Information
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NPI Number | 1386409050
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Entity Type | Individual
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Provider Name | RONALD NARAG BANCUD
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Gender | Male
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 655 STRAITS TPKE
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City | WATERTOWN
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State | CT
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Zip | 06795-3369
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Country | US
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Telephone | 860-782-6069
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Fax |
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Provider Business Mailing Address
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Address Line | 191 CORBIN RDG
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City | BRISTOL
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State | CT
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Zip | 06010-9484
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Country | US
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Telephone | 718-313-7706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10198
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License Number State | CT
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