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General NPI Number Information
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NPI Number | 1174185110
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Entity Type | Individual
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Provider Name | RYAN JUDY MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2019
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 2400 MARYLAND RD STE 20
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1732
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Country | US
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Telephone | 800-321-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W MONTGOMERY AVE APT 1
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City | ARDMORE
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State | PA
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Zip | 19003-1421
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Country | US
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Telephone |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MT217410
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 25MA12386400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | MD484985
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License Number State | PA
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