Healthcare Provider Details

I. General information

NPI: 1710440417
Provider Name (Legal Business Name): RYNA MASSIEL ESCANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E 102ND ST APT 14A
NEW YORK NY
10029-5935
US

IV. Provider business mailing address

220 E 102ND ST APT 14A
NEW YORK NY
10029-5935
US

V. Phone/Fax

Practice location:
  • Phone: 917-660-6880
  • Fax:
Mailing address:
  • Phone: 917-660-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: