Provider Demographics
NPI:1437570546
Name:DORONIO, RICHARD SR
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:DORONIO
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 E PRYOR DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4408
Mailing Address - Country:US
Mailing Address - Phone:559-433-6521
Mailing Address - Fax:
Practice Address - Street 1:2452 E PRYOR DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4408
Practice Address - Country:US
Practice Address - Phone:559-433-6521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN193719164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse