Provider Demographics
NPI:1730479692
Name:TUFTS, RYAN EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:EUGENE
Last Name:TUFTS
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 1:10 GLENVILLE ST UNIT 206
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-3664
Mailing Address - Country:US
Mailing Address - Phone:305-310-5181
Mailing Address - Fax:
Practice Address - Street 1:10 GLENVILLE ST UNIT 206
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3664
Practice Address - Country:US
Practice Address - Phone:305-310-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279980207L00000X
CT68680207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology