Healthcare Provider Details

I. General information

NPI: 1235533704
Provider Name (Legal Business Name): RYAN HUGH MCGAHAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 10/06/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 READE PLACE VASSAR HOSPITAL
POUGHKEEPSIE NY
12601
US

IV. Provider business mailing address

1305 WALT WHITMAN RD STE 300
MELVILLE NY
11747-4300
US

V. Phone/Fax

Practice location:
  • Phone: 845-430-9476
  • Fax:
Mailing address:
  • Phone: 888-240-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number612053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: