Provider Demographics
NPI:1326311523
Name:RYAN SHEA ASSOCIATES INC.
Entity Type:Organization
Organization Name:RYAN SHEA ASSOCIATES INC.
Other - Org Name:DR. RYAN SHEA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:617-462-4890
Mailing Address - Street 1:978 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1546
Mailing Address - Country:US
Mailing Address - Phone:781-337-0674
Mailing Address - Fax:781-337-0285
Practice Address - Street 1:978 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1546
Practice Address - Country:US
Practice Address - Phone:781-337-0674
Practice Address - Fax:781-337-0285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4623152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty