Healthcare Provider Details

I. General information

NPI: 1154618031
Provider Name (Legal Business Name): RYAN SIOCO UY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RYAN UY MD

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 W GOVERNOR RD STE 320
HERSHEY PA
17033-2310
US

IV. Provider business mailing address

PO BOX 37215
BALTIMORE MD
21297-3215
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-7235
  • Fax: 717-531-0781
Mailing address:
  • Phone: 202-476-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036136138
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberMD044795
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberMD484927
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: