Provider Demographics
NPI:1104929033
Name:MEINSTEREIFEL, RONALD LEE (MA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:LEE
Last Name:MEINSTEREIFEL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:57 CAPITOL DRIVE
Mailing Address - City:NELSON
Mailing Address - State:PA
Mailing Address - Zip Code:16940-0242
Mailing Address - Country:US
Mailing Address - Phone:570-827-2574
Mailing Address - Fax:570-827-2574
Practice Address - Street 1:57 CAPITOL DR.
Practice Address - Street 2:
Practice Address - City:NELSON
Practice Address - State:PA
Practice Address - Zip Code:16940-0242
Practice Address - Country:US
Practice Address - Phone:570-827-2574
Practice Address - Fax:570-827-2574
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006437-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014722760002Medicaid