Healthcare Provider Details

I. General information

NPI: 1184994832
Provider Name (Legal Business Name): DEBRA RYAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 OLD ORCHARD ST
WHITE PLAINS NY
10604-1049
US

IV. Provider business mailing address

1606 OLD ORCHARD ST
WHITE PLAINS NY
10604-1049
US

V. Phone/Fax

Practice location:
  • Phone: 914-948-7271
  • Fax: 914-428-2222
Mailing address:
  • Phone: 914-948-7271
  • Fax: 914-428-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number372016-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: