Provider Demographics
NPI:1073090916
Name:CRYAN, ERIC MICHAEL (DVM)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:MICHAEL
Last Name:CRYAN
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8352 TERMINAL RD STE H
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1454
Mailing Address - Country:US
Mailing Address - Phone:866-946-7387
Mailing Address - Fax:703-659-9214
Practice Address - Street 1:8352 TERMINAL RD STE H
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1454
Practice Address - Country:US
Practice Address - Phone:866-946-7387
Practice Address - Fax:703-659-9214
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0301200619174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VABC7856430OtherDEA