Provider Demographics
NPI:1992716005
Name:COFFEY, RONALD R (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:R
Last Name:COFFEY
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 1:188 QUASSAICK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553
Mailing Address - Country:US
Mailing Address - Phone:845-565-5020
Mailing Address - Fax:845-565-5027
Practice Address - Street 1:188 QUASSAICK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:845-565-5020
Practice Address - Fax:845-565-5027
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000933OtherCTC
NY08016735OtherRAILROAD MEDICARE
NY10031951OtherCDPHP
NY2225598002OtherCIGNA
NY2C7753OtherHEALTHNET
NY5791091OtherAETNA
NYOR0000216OtherSELECTPRO
NY01206477Medicaid
NY58368OtherOPERATING ENGINEERS
NY827719OtherUNITED HEALTHCARE
NY98339OtherUS HEALTHCARE AETNA
NY350767OtherMVP
NY5900820OtherGHI PPO
NY2080633OtherUS HEALTHCARE
NY50436OtherGHI HMO
NY115828OtherWELLCARE
NYP2167821OtherOXFORD
NYOR0000216OtherSELECTPRO
NY98339OtherUS HEALTHCARE AETNA