Provider Demographics
NPI:1659384014
Name:LINCOW, RONALD BRUCE (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:BRUCE
Last Name:LINCOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1705 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1312
Mailing Address - Country:US
Mailing Address - Phone:215-338-1811
Mailing Address - Fax:215-338-3606
Practice Address - Street 1:2201 RIDGEWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1196
Practice Address - Country:US
Practice Address - Phone:610-375-6226
Practice Address - Fax:484-509-2933
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013632208VP0000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102093834-0001Medicaid
PA106646N4GMedicare PIN
I67574Medicare UPIN