Provider Demographics
NPI:1073623385
Name:SERNIUK, RONALD ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ANDREW
Last Name:SERNIUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:55 NEWTON SPARTA RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860
Mailing Address - Country:US
Mailing Address - Phone:973-383-0908
Mailing Address - Fax:973-383-1356
Practice Address - Street 1:55 NEWTON SPARTA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:973-383-0908
Practice Address - Fax:973-383-1356
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA33975207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2040301Medicaid
427032Medicare ID - Type Unspecified
NJ2040301Medicaid