Provider Demographics
NPI:1720049232
Name:RYAN, TODD C (DO)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:C
Last Name:RYAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:10 PARSONAGE RD
Mailing Address - Street 2:FIFTH FLOOR, SUITE 500
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2429
Mailing Address - Country:US
Mailing Address - Phone:732-494-6226
Mailing Address - Fax:734-494-8762
Practice Address - Street 1:10 PARSONAGE RD
Practice Address - Street 2:FIFTH FLOOR, SUITE 500
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2429
Practice Address - Country:US
Practice Address - Phone:732-494-6226
Practice Address - Fax:734-494-8762
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07384400207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ063136BBFMedicare PIN
NJH44442Medicare UPIN