Provider Demographics
NPI:1528113057
Name:BARONE, RALPH J (MS)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:J
Last Name:BARONE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-5934
Mailing Address - Country:US
Mailing Address - Phone:631-471-5644
Mailing Address - Fax:
Practice Address - Street 1:106 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-5934
Practice Address - Country:US
Practice Address - Phone:631-471-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist