Provider Demographics
NPI:1275617011
Name:RYAN, MARJORIE F (MSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:F
Last Name:RYAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SEA CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SEA CLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:11579-1425
Mailing Address - Country:US
Mailing Address - Phone:516-671-2463
Mailing Address - Fax:516-656-0168
Practice Address - Street 1:267 SEA CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SEA CLIFF
Practice Address - State:NY
Practice Address - Zip Code:11579-1253
Practice Address - Country:US
Practice Address - Phone:516-671-4217
Practice Address - Fax:516-656-0168
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-035586-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical