Provider Demographics
NPI:1891947933
Name:RYAN, LORI HART (PT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:HART
Last Name:RYAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-6749
Mailing Address - Country:US
Mailing Address - Phone:518-428-2930
Mailing Address - Fax:518-273-7879
Practice Address - Street 1:108 SENECA ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-6749
Practice Address - Country:US
Practice Address - Phone:518-428-2930
Practice Address - Fax:518-273-7879
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007228-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics