Provider Demographics
NPI:1578013785
Name:MILLOY, RYAN (PA-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MILLOY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E WESNER RD
Mailing Address - Street 2:
Mailing Address - City:BLANDON
Mailing Address - State:PA
Mailing Address - Zip Code:19510-9613
Mailing Address - Country:US
Mailing Address - Phone:484-599-1358
Mailing Address - Fax:
Practice Address - Street 1:716 N PARK RD STE 1
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2912
Practice Address - Country:US
Practice Address - Phone:610-375-0544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant