Provider Demographics
NPI:1447286034
Name:DR RONALD J GAUDIO & ASSOCIATES INC
Entity type:Organization
Organization Name:DR RONALD J GAUDIO & ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GAUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-363-3377
Mailing Address - Street 1:34 N SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1902
Mailing Address - Country:US
Mailing Address - Phone:740-363-3377
Mailing Address - Fax:
Practice Address - Street 1:34 N SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1902
Practice Address - Country:US
Practice Address - Phone:740-363-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0668559Medicaid
OH0668559Medicaid