Provider Demographics
NPI:1376040295
Name:SLEPOY, RYAN HENRY
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:HENRY
Last Name:SLEPOY
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 1:8 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2527
Mailing Address - Country:US
Mailing Address - Phone:978-580-6646
Mailing Address - Fax:
Practice Address - Street 1:21 EASTMAN AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6744
Practice Address - Country:US
Practice Address - Phone:978-635-0229
Practice Address - Fax:978-635-0123
Is Sole Proprietor?:No
Enumeration Date:2018-04-08
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2511213ES0103X
NH0377213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery