Provider Demographics
NPI:1194865469
Name:CIACCIA, RONALD SILVIO (OTR&L)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:SILVIO
Last Name:CIACCIA
Suffix:
Gender:M
Credentials:OTR&L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HIGHPOINTE WAY.
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-9610
Mailing Address - Country:US
Mailing Address - Phone:917-837-8770
Mailing Address - Fax:917-837-8770
Practice Address - Street 1:30 HIGHPOINTE WAY.
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-9610
Practice Address - Country:US
Practice Address - Phone:917-837-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012203225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist