Healthcare Provider Details

I. General information

NPI: 1669867628
Provider Name (Legal Business Name): RYAN ANDREW VESNY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 E BUTLER PIKE
AMBLER PA
19002-2310
US

IV. Provider business mailing address

6 CRESTWOOD CT APT A
LANSDALE PA
19446-1285
US

V. Phone/Fax

Practice location:
  • Phone: 215-643-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD478592
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: