Provider Demographics
NPI:1972045904
Name:STYKA, RONALD JASON (PSYD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JASON
Last Name:STYKA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 45TH ST FRNT B
Mailing Address - Street 2:SUITE 705
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4907
Mailing Address - Country:US
Mailing Address - Phone:347-974-0936
Mailing Address - Fax:
Practice Address - Street 1:19 W 45TH ST FRNT B
Practice Address - Street 2:SUITE 705
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:347-974-0936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021946-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical