Provider Demographics
NPI:1275127078
Name:JOHN RYAN & ASSOCIATES
Entity Type:Organization
Organization Name:JOHN RYAN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMETCHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-884-3351
Mailing Address - Street 1:2A 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEASIDE HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08751-1506
Mailing Address - Country:US
Mailing Address - Phone:908-884-3351
Mailing Address - Fax:
Practice Address - Street 1:2A 8TH AVE
Practice Address - Street 2:
Practice Address - City:SEASIDE HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08751-1506
Practice Address - Country:US
Practice Address - Phone:908-884-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health