Provider Demographics
NPI:1790828929
Name:DIAMANT, RONALD M (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:M
Last Name:DIAMANT
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 1:2232 BRIGHAM ST APT 2G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-6129
Mailing Address - Country:US
Mailing Address - Phone:718-648-0582
Mailing Address - Fax:
Practice Address - Street 1:2232 BRIGHAM ST APT 2G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-6129
Practice Address - Country:US
Practice Address - Phone:718-648-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0036716OtherGHI PROVIDER NUMBER
NYCO-1994-5OtherWORKERS COMPENSATION NO.
NYCO-1994-5OtherWORKERS COMPENSATION NO.