Provider Demographics
NPI:1659399475
Name:STRAM, RONALD L (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:STRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 ADAMS PL
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3224
Mailing Address - Country:US
Mailing Address - Phone:518-689-2244
Mailing Address - Fax:518-689-2081
Practice Address - Street 1:90 ADAMS PL
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-3224
Practice Address - Country:US
Practice Address - Phone:518-689-2244
Practice Address - Fax:845-334-2816
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1886141207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E34571Medicare UPIN