Provider Demographics
NPI:1588996854
Name:BIXON, RONDA (MD)
Entity type:Individual
Prefix:DR
First Name:RONDA
Middle Name:
Last Name:BIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RONDA
Other - Middle Name:
Other - Last Name:BIXON BENSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:45 EAST END AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7983
Mailing Address - Country:US
Mailing Address - Phone:212-772-7375
Mailing Address - Fax:212-327-4221
Practice Address - Street 1:45 EAST END AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7983
Practice Address - Country:US
Practice Address - Phone:212-772-7375
Practice Address - Fax:212-327-4221
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1503792085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology