Healthcare Provider Details

I. General information

NPI: 1326821570
Provider Name (Legal Business Name): RYAN VERITY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

IV. Provider business mailing address

55 QUEENSBERRY ST APT 9
BOSTON MA
02215-4843
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-3274
  • Fax:
Mailing address:
  • Phone: 306-380-5950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number3013721
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: