Healthcare Provider Details

I. General information

NPI: 1770109761
Provider Name (Legal Business Name): JOHN RYAN GEDNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BOSTON POST RD STE 240
DARIEN CT
06820-3667
US

IV. Provider business mailing address

330 BOSTON POST RD STE 240
DARIEN CT
06820-3667
US

V. Phone/Fax

Practice location:
  • Phone: 203-548-7858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberLL84642
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number85372
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: