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General NPI Number Information
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NPI Number | 1124119409
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Entity Type | Individual
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Provider Name | JOSEPH FRANCIS RYAN A.S.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 555 WILLARD AVE 116A
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City | NEWINGTON
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State | CT
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Zip | 06111-2631
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Country | US
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Telephone | 860-594-6320
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Fax | 860-667-8642
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Provider Business Mailing Address
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Address Line | 85 PEPPER BUSH LN
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City | NEWINGTON
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State | CT
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Zip | 06111-4242
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Country | US
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Telephone | 860-667-1901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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