Provider Demographics
NPI:1881013928
Name:MIYAUCHI, RYOSUKE (MD)
Entity Type:Individual
Prefix:
First Name:RYOSUKE
Middle Name:
Last Name:MIYAUCHI
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 1:106-1 MIKURA
Mailing Address - Street 2:
Mailing Address - City:SAITAMASHI
Mailing Address - State:SAITAMAKEN
Mailing Address - Zip Code:3370033
Mailing Address - Country:JP
Mailing Address - Phone:048-684-3084
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:646-421-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program