Provider Demographics
NPI:1639271182
Name:ONDREJCA, RONALD STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:STEPHEN
Last Name:ONDREJCA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2197 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:COPLAY
Mailing Address - State:PA
Mailing Address - Zip Code:18037-2282
Mailing Address - Country:US
Mailing Address - Phone:610-261-9765
Mailing Address - Fax:
Practice Address - Street 1:3716 LEHIGH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-3437
Practice Address - Country:US
Practice Address - Phone:610-437-2040
Practice Address - Fax:610-437-2024
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006972-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARO1003119OtherASHN PARTICIPANT
PA897847OtherHIGHMARK PARTICIPANT
PA2125843OtherAETNA PARTICIPANT
PAON-001071Medicare ID - Type UnspecifiedMEDICARE PARTICIPANT