Provider Demographics
NPI:1962771428
Name:UDOVICH, RAMONA MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:MARIE
Last Name:UDOVICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 MAIN STREET
Mailing Address - Street 2:P.O. BOX 631
Mailing Address - City:RICHFIELD SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13439-0631
Mailing Address - Country:US
Mailing Address - Phone:315-858-0610
Mailing Address - Fax:315-858-2440
Practice Address - Street 1:93 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13439-4504
Practice Address - Country:US
Practice Address - Phone:315-858-0610
Practice Address - Fax:315-858-2440
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255598-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse