Provider Demographics
NPI:1174529812
Name:ROVETO, RONALD O (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:O
Last Name:ROVETO
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 1:43 HOFSTRA DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1814
Mailing Address - Country:US
Mailing Address - Phone:516-692-8455
Mailing Address - Fax:516-692-8455
Practice Address - Street 1:43 HOFSTRA DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1814
Practice Address - Country:US
Practice Address - Phone:516-692-8455
Practice Address - Fax:516-692-8455
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169771207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01240922Medicaid
NY01240922Medicaid
NY86F701Medicare ID - Type UnspecifiedEMPIRE MEDICARE