Healthcare Provider Details

I. General information

NPI: 1427092386
Provider Name (Legal Business Name): RYAN G FIELDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 HIGHWAY 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

PO BOX 307
NEPTUNE NJ
07754-0307
US

V. Phone/Fax

Practice location:
  • Phone: 732-897-0200
  • Fax: 732-897-0263
Mailing address:
  • Phone: 732-897-0200
  • Fax: 732-897-0263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number25MB08009300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB08009300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: