Provider Demographics
NPI:1518204379
Name:FARAON, RONALDO T (RN)
Entity Type:Individual
Prefix:MR
First Name:RONALDO
Middle Name:T
Last Name:FARAON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 SEDGWICK AVE
Mailing Address - Street 2:5E
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2604
Mailing Address - Country:US
Mailing Address - Phone:914-207-0421
Mailing Address - Fax:
Practice Address - Street 1:555 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2925
Practice Address - Country:US
Practice Address - Phone:212-376-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY650243-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse