Provider Demographics
NPI:1629045695
Name:ADLER, RONIT (MD)
Entity type:Individual
Prefix:DR
First Name:RONIT
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 JOHN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702
Mailing Address - Country:US
Mailing Address - Phone:631-661-0400
Mailing Address - Fax:631-661-0463
Practice Address - Street 1:51 JOHN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702
Practice Address - Country:US
Practice Address - Phone:631-661-0400
Practice Address - Fax:631-661-0463
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2008-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAN174108174400000X
NY174108207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No174400000XOther Service ProvidersSpecialist
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE86330Medicare UPIN
NY82F541Medicare ID - Type Unspecified