Provider Demographics
NPI:1902094824
Name:RONALD J. TADDEO, M.D., P.C
Entity Type:Organization
Organization Name:RONALD J. TADDEO, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-447-7560
Mailing Address - Street 1:4 PHYLLIS DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2900
Mailing Address - Country:US
Mailing Address - Phone:631-447-7560
Mailing Address - Fax:631-447-7561
Practice Address - Street 1:4 PHYLLIS DR
Practice Address - Street 2:SUITE H
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2900
Practice Address - Country:US
Practice Address - Phone:631-447-7560
Practice Address - Fax:631-447-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty