Provider Demographics
NPI:1215257985
Name:RONALD NESCHIS, M.D. P.C.
Entity type:Organization
Organization Name:RONALD NESCHIS, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NESCHIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-834-3470
Mailing Address - Street 1:18 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-4139
Mailing Address - Country:US
Mailing Address - Phone:914-834-3470
Mailing Address - Fax:
Practice Address - Street 1:18 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-4139
Practice Address - Country:US
Practice Address - Phone:914-834-3470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093459-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY515623OtherMEDICARE PECAN #
NYB15827Medicare UPIN