Provider Demographics
NPI:1780018499
Name:RAGNONE, MARY (BSNRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:RAGNONE
Suffix:
Gender:F
Credentials:BSNRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 VAN WINKLE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2313
Mailing Address - Country:US
Mailing Address - Phone:973-423-4916
Mailing Address - Fax:
Practice Address - Street 1:681 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1421
Practice Address - Country:US
Practice Address - Phone:973-278-1000
Practice Address - Fax:973-278-1709
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06682600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse