Provider Demographics
NPI:1467405910
Name:BACSKAI, RONALD J JR (D C)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:BACSKAI
Suffix:JR
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3614
Mailing Address - Country:US
Mailing Address - Phone:610-489-8800
Mailing Address - Fax:610-489-8821
Practice Address - Street 1:109 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3614
Practice Address - Country:US
Practice Address - Phone:610-489-8800
Practice Address - Fax:610-489-8821
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006362L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA810623Medicare ID - Type UnspecifiedMEDICARE