Provider Demographics
NPI:1447760699
Name:RONZONI, JAIME (NP)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:RONZONI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MAPLE AVE STE G-1
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4767
Mailing Address - Country:US
Mailing Address - Phone:914-683-0443
Mailing Address - Fax:914-380-1330
Practice Address - Street 1:30 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1041
Practice Address - Country:US
Practice Address - Phone:914-328-2151
Practice Address - Fax:914-380-1330
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily