Provider Demographics
NPI:1851396360
Name:GALLUCCIO, RONALD WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WAYNE
Last Name:GALLUCCIO
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 1:184 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5154
Mailing Address - Country:US
Mailing Address - Phone:212-737-2270
Mailing Address - Fax:212-249-2054
Practice Address - Street 1:184 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5154
Practice Address - Country:US
Practice Address - Phone:212-737-2270
Practice Address - Fax:212-249-2054
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148195174400000X, 207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD91700Medicare UPIN
00F081Medicare PIN