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General NPI Number Information
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NPI Number | 1538354378
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Entity Type | Organization
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Legal Business Name | POMONA MEDICAL DIAGNOSTICS
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 100 PHILLIPS HILL RD
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City | NEW CITY
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State | NY
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Zip | 10956-4134
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Country | US
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Telephone | 845-634-5650
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1984
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City | NEW CITY
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State | NY
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Zip | 10956-8584
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Country | US
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Telephone | 845-634-5650
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTIONER
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Name | DR. RONALD DISCENZA
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Credential | M.D.
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Telephone | 845-634-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 140670
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License Number State | NY
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