Provider Demographics
NPI:1023069044
Name:D'AMICO, RONALD S (DPM)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:D'AMICO
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:7593 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3538
Mailing Address - Country:US
Mailing Address - Phone:315-457-2021
Mailing Address - Fax:315-457-2071
Practice Address - Street 1:7593 MORGAN RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-3538
Practice Address - Country:US
Practice Address - Phone:315-457-2021
Practice Address - Fax:315-457-2071
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN0029341213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0665670001Medicare NSC