Provider Demographics
NPI:1972586014
Name:RYAN, GAYLE BLANCHARD (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:BLANCHARD
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-4529
Mailing Address - Country:US
Mailing Address - Phone:717-256-3075
Mailing Address - Fax:
Practice Address - Street 1:1349 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-4529
Practice Address - Country:US
Practice Address - Phone:717-256-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445743208VP0000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine