Provider Demographics
NPI:1457486656
Name:LADUCA, RONALD WILLIAM
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WILLIAM
Last Name:LADUCA
Suffix:
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 1:400 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092
Mailing Address - Country:US
Mailing Address - Phone:716-754-8970
Mailing Address - Fax:716-754-8970
Practice Address - Street 1:400 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092
Practice Address - Country:US
Practice Address - Phone:716-754-8970
Practice Address - Fax:716-754-8970
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033337-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ300222020Medicare PIN