Provider Demographics
NPI:1609986934
Name:RLD MEDICAL SERVICES, PC
Entity type:Organization
Organization Name:RLD MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:DONIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-639-2067
Mailing Address - Street 1:45 S ROUTE 9W STE 41 #114
Mailing Address - Street 2:
Mailing Address - City:WEST HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10993-1053
Mailing Address - Country:US
Mailing Address - Phone:914-639-2067
Mailing Address - Fax:315-612-9793
Practice Address - Street 1:3751 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1815
Practice Address - Country:US
Practice Address - Phone:718-601-2700
Practice Address - Fax:718-601-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02176649Medicaid
NYWAA851Medicare UPIN
NY05926Medicare PIN