Provider Demographics
NPI:1235229485
Name:RYAN, ERIKA E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:E
Last Name:RYAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 STOKES RD
Mailing Address - Street 2:IRONSTONE BUILDING A6
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2904
Mailing Address - Country:US
Mailing Address - Phone:609-654-6995
Mailing Address - Fax:
Practice Address - Street 1:520 STOKES RD
Practice Address - Street 2:IRONSTONE BUILDING A6
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2904
Practice Address - Country:US
Practice Address - Phone:609-654-6995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI00435900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist