Provider Demographics
NPI:1548498694
Name:RONCA, ERIN ANN
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ANN
Last Name:RONCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 THREE VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1319
Mailing Address - Country:US
Mailing Address - Phone:631-786-3327
Mailing Address - Fax:
Practice Address - Street 1:4 THREE VILLAGE LN
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1319
Practice Address - Country:US
Practice Address - Phone:631-786-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-28
Last Update Date:2009-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008589-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor