Provider Demographics
NPI:1235847435
Name:PERRY, RYNE
Entity Type:Individual
Prefix:
First Name:RYNE
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:SHOKAN
Mailing Address - State:NY
Mailing Address - Zip Code:12481-0167
Mailing Address - Country:US
Mailing Address - Phone:856-389-7634
Mailing Address - Fax:
Practice Address - Street 1:6094 MAIN ST
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12485-7701
Practice Address - Country:US
Practice Address - Phone:518-589-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist