Provider Demographics
NPI:1194335380
Name:RAGOGNA, RENEE ANNE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:ANNE
Last Name:RAGOGNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:ANNE
Other - Last Name:CALMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 ROLLING LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1214
Mailing Address - Country:US
Mailing Address - Phone:917-589-5832
Mailing Address - Fax:
Practice Address - Street 1:59 38TH ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-1101
Practice Address - Country:US
Practice Address - Phone:516-274-8972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009001-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant