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Physician Compare National (NPI:1386680122)

HEALTHCARE PROVIDER: RONNIE KAGLE LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1386680122
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 3779656251
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20080716000431
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name KAGLE
Individual professional last name
Provider First Name RONNIE
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1984
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2521 PALISADE AVE
Group Practice or individual's line 1 address
City BRONX
Group Practice or individual's city
State NY
Group Practice or individual's state
Zip Code 104636137
Group Practice or individual's zip code (9 digits when available)
Phone Number 9145223531
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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