Provider Demographics
NPI:1477895001
Name:SUGARMAN, RYAN BRETT (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:BRETT
Last Name:SUGARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1112
Mailing Address - Country:US
Mailing Address - Phone:516-559-1312
Mailing Address - Fax:516-515-5959
Practice Address - Street 1:1101 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553
Practice Address - Country:US
Practice Address - Phone:516-559-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
NY279012207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program