Provider Demographics
NPI:1225323298
Name:DR RONNA, LLC
Entity Type:Organization
Organization Name:DR RONNA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:RONNA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-707-5110
Mailing Address - Street 1:96 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-5609
Mailing Address - Country:US
Mailing Address - Phone:973-256-2166
Mailing Address - Fax:
Practice Address - Street 1:96 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-5609
Practice Address - Country:US
Practice Address - Phone:973-256-2166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty