Provider Demographics
NPI:1801817143
Name:SKRIPAK, RYAN PATRICK (DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PATRICK
Last Name:SKRIPAK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 VALLEY BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1848
Mailing Address - Country:US
Mailing Address - Phone:201-438-5038
Mailing Address - Fax:
Practice Address - Street 1:2 CHANGEBRIDGE RD
Practice Address - Street 2:SUITE F
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-8947
Practice Address - Country:US
Practice Address - Phone:973-917-3134
Practice Address - Fax:973-917-3138
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01170600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist