Healthcare Provider Details

I. General information

NPI: 1871419283
Provider Name (Legal Business Name): RYYAN JUNAID AKHTAR PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 HIGHLAND AVE
NEEDHAM MA
02492-2615
US

IV. Provider business mailing address

1237 HIGHLAND AVE
NEEDHAM MA
02492-2615
US

V. Phone/Fax

Practice location:
  • Phone: 936-465-0095
  • Fax:
Mailing address:
  • Phone: 936-465-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA10256
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: