Provider Demographics
NPI:1790230993
Name:RYAN, PATRICIA CLAIRE
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:CLAIRE
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 DAVENPORT PLACE
Mailing Address - Street 2:
Mailing Address - City:N BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2601
Mailing Address - Country:US
Mailing Address - Phone:516-375-1061
Mailing Address - Fax:
Practice Address - Street 1:34 DAVENPORT PLACE
Practice Address - Street 2:
Practice Address - City:N BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2601
Practice Address - Country:US
Practice Address - Phone:516-375-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist