Provider Demographics
NPI:1487739660
Name:MANN, RONALD LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LAWRENCE
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4431
Mailing Address - Country:US
Mailing Address - Phone:914-962-7712
Mailing Address - Fax:914-962-7001
Practice Address - Street 1:1888 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4431
Practice Address - Country:US
Practice Address - Phone:914-962-7712
Practice Address - Fax:914-962-7001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149230207X00000X
NJ25MA03997500207X00000X
CAG46552207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WS0000964OtherSELECTPRO
0D5313OtherPHS
149230OtherHIP
NY010149230NY01OtherANTHEM
WS395OtherOXFORD
721434OtherUNITED HEALTH CARE
4201143OtherAETNA
0926779002OtherCIGNA
149230OtherMAGNACARE
721434OtherUNITED HEALTH CARE
149230OtherMAGNACARE