Healthcare Provider Details

I. General information

NPI: 1508440009
Provider Name (Legal Business Name): RYAN CIPRIANI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 EGG HARBOR RD STE B
SEWELL NJ
08080-9427
US

IV. Provider business mailing address

111 EGG HARBOR RD STE B
SEWELL NJ
08080-9427
US

V. Phone/Fax

Practice location:
  • Phone: 856-297-0155
  • Fax:
Mailing address:
  • Phone: 856-297-0155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00765300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: