Provider Demographics
NPI:1942469614
Name:MUKERJEE, RONICA (NP)
Entity type:Individual
Prefix:
First Name:RONICA
Middle Name:
Last Name:MUKERJEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 BLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3503
Mailing Address - Country:US
Mailing Address - Phone:646-785-7452
Mailing Address - Fax:646-491-7441
Practice Address - Street 1:2185 CLARENDON RD STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6110
Practice Address - Country:US
Practice Address - Phone:646-785-7452
Practice Address - Fax:718-523-5833
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335526363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331058Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331978Medicare Oscar/Certification