Ronica Bisram
Individual provider Active NPI Licensed Practical Nurse · Bellport, NY
NPI 1437436409 · NPPES record last updated Nov 4, 2011
Key facts
- NPI
- 1437436409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 307570 (NY)
- Practice address
- 82 Pace Ave
Bellport, NY 11713-1513 - Phone
- (631) 803-2644
- NPI assigned
- Nov 4, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 307570 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 307570 | NY | Yes |
Addresses
Primary practice location
82 Pace Ave
Bellport, NY 11713-1513
Mailing address
82 Pace Ave
Bellport, NY 11713-1513
Phone (631) 803-2644
Other providers in Bellport, NY
- Bellport Chiropractic, P.C.
- Gary Andrew Bergmann
- Allison Eve Berman
- Kaustubh Bhatt
- Lynsey Bieringer
- Sarojini V. Bisram
- Cheryl Ann Bittner
- BJ'S Wholesale Club Inc.
- Meri Blandi
- Tanesha Booker
All providers in Bellport, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.