Provider Demographics
NPI:1629299839
Name:SAVARESE, RONALD J (DO)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:SAVARESE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1703 INNOVATION DR STE 108
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-8815
Mailing Address - Country:US
Mailing Address - Phone:717-849-5576
Mailing Address - Fax:717-849-5596
Practice Address - Street 1:1703 INNOVATION DR STE 4120
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8815
Practice Address - Country:US
Practice Address - Phone:717-849-5576
Practice Address - Fax:717-849-5596
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014139207RC0000X, 207RC0001X, 207R00000X
NJ25MB08067600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024817000002Medicaid