Provider Demographics
NPI:1013982941
Name:DUNPHY, RONALD MICHAEL (DO)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:MICHAEL
Last Name:DUNPHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ISLIP AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3222
Mailing Address - Country:US
Mailing Address - Phone:631-581-2433
Mailing Address - Fax:631-581-2057
Practice Address - Street 1:150 ISLIP AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-3222
Practice Address - Country:US
Practice Address - Phone:631-581-2433
Practice Address - Fax:631-581-2057
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194788208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01837154Medicaid
NY1434851OtherEMPIRE UHC
NYG21381Medicare UPIN
NY027961Medicare PIN