Provider Demographics
NPI:1194225334
Name:RYAN, ALLISON C
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:C
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:C
Other - Last Name:MAHAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2200 BURDETT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 BURDETT AVE STE 101
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2451
Practice Address - Country:US
Practice Address - Phone:518-326-0329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008977156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician