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General NPI Number Information
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NPI Number | 1720660426
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Entity Type | Individual
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Provider Name | RONNY ANTONY DO
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Gender | Male
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 259 1ST ST RM 291
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City | MINEOLA
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State | NY
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Zip | 11501-3957
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Country | US
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Telephone | 516-663-8963
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Fax | 516-663-8964
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Provider Business Mailing Address
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Address Line | 700 HICKSVILLE RD STE 205
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City | BETHPAGE
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State | NY
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Zip | 11714-3472
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Country | US
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Telephone | 465-013-2296
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 330451
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 330451
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License Number State | NY
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