Healthcare Provider Details

I. General information

NPI: 1225364110
Provider Name (Legal Business Name): SYLVIA RYAN, O.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2974 N ALMA SCHOOL RD STE 3
CHANDLER AZ
85224-6713
US

IV. Provider business mailing address

3370 E CANARY WAY
CHANDLER AZ
85286-5682
US

V. Phone/Fax

Practice location:
  • Phone: 480-899-0188
  • Fax: 480-899-0199
Mailing address:
  • Phone: 602-625-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number850
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number850
License Number StateAZ

VIII. Authorized Official

Name: DR. SYLVIA RYAN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 480-899-0188