Healthcare Provider Details

I. General information

NPI: 1689681587
Provider Name (Legal Business Name): KATHRYN RYAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ALWINE RD SUITE 104
SAXONBURG PA
16056-8604
US

IV. Provider business mailing address

101 ALWINE RD STE 104
SAXONBURG PA
16056-8604
US

V. Phone/Fax

Practice location:
  • Phone: 724-352-8840
  • Fax: 724-352-9033
Mailing address:
  • Phone: 724-352-8840
  • Fax: 724-352-9033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS006084L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: