Provider Demographics
NPI:1609411487
Name:ROMAN, RYAN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:ROMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-7605
Mailing Address - Country:US
Mailing Address - Phone:724-991-5725
Mailing Address - Fax:
Practice Address - Street 1:3053 NEW GERMANY RD
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-3516
Practice Address - Country:US
Practice Address - Phone:814-472-1100
Practice Address - Fax:814-472-6445
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist