Provider Demographics
NPI:1215101969
Name:RONALD P. SINACK
Entity type:Organization
Organization Name:RONALD P. SINACK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-333-5063
Mailing Address - Street 1:221 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1161
Mailing Address - Country:US
Mailing Address - Phone:732-505-8277
Mailing Address - Fax:
Practice Address - Street 1:701 STUYVESANT AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1823
Practice Address - Country:US
Practice Address - Phone:848-333-5063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z131Medicare PIN
NJ021517Medicare PIN