Provider Demographics
NPI:1508991209
Name:HUTCHINS, RONALD WAYNE JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WAYNE
Last Name:HUTCHINS
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 SIBLEY PL
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2512
Mailing Address - Country:US
Mailing Address - Phone:518-429-2308
Mailing Address - Fax:518-429-2320
Practice Address - Street 1:135 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3105
Practice Address - Country:US
Practice Address - Phone:518-429-2308
Practice Address - Fax:518-429-2320
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer