Provider Demographics
NPI:1609526789
Name:ENG, RYAN K (DO)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:K
Last Name:ENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 LAKESIDE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-4314
Mailing Address - Country:US
Mailing Address - Phone:862-621-5815
Mailing Address - Fax:
Practice Address - Street 1:100 10TH AVE STE 3A-08
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4718
Practice Address - Country:US
Practice Address - Phone:212-259-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program