Provider Demographics
NPI:1578532727
Name:REISINGER, RONALD D (PAC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:REISINGER
Suffix:
Gender:M
Credentials:PAC
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Other - Credentials:
Mailing Address - Street 1:11277 VERNON PLACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3717
Mailing Address - Country:US
Mailing Address - Phone:814-724-1252
Mailing Address - Fax:814-333-8871
Practice Address - Street 1:11277 VERNON PLACE
Practice Address - Street 2:SUITE 200
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3717
Practice Address - Country:US
Practice Address - Phone:814-724-1252
Practice Address - Fax:814-333-8871
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2016-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001445L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA141722EMHMedicare PIN