Provider Demographics
NPI:1134305196
Name:DOCKERY, RYAN NELLO (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:NELLO
Last Name:DOCKERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:42 MARKET ST
Mailing Address - Street 2:PO BOX 698
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1747
Mailing Address - Country:US
Mailing Address - Phone:315-265-4924
Mailing Address - Fax:315-268-1723
Practice Address - Street 1:321 GENESEE ST
Practice Address - Street 2:ONEIDA HEALTHCARE CENTER
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2611
Practice Address - Country:US
Practice Address - Phone:315-265-4924
Practice Address - Fax:315-268-1723
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2017-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2761612085R0202X
LAPGY.2.TUL-RAD2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology