Provider Demographics
NPI:1033546460
Name:RYANS, BRANDI (LMT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:RYANS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 EAST 11TH STREET
Mailing Address - Street 2:SUITE 609
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:646-417-1151
Mailing Address - Fax:
Practice Address - Street 1:80 E 11TH ST
Practice Address - Street 2:SUITE 609
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6811
Practice Address - Country:US
Practice Address - Phone:646-417-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025214-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist