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NPI 1205688140

NPI 1205688140 : RYAN WARD : WATERBURY, CT

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General NPI Number Information
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    NPI Number           |    1205688140
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    Entity Type          |    Individual 
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    Provider Name        |    RYAN WARD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/03/2024
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    Last Update Date     |    05/31/2025
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Provider Practice Location Address
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    Address Line         |    56 FRANKLIN ST 
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    City                 |    WATERBURY
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    State                |    CT
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    Zip                  |    06706-1253
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    Country              |    US
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    Telephone            |    120-370-9600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    380 MATHER ST APT 5008 
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    City                 |    HAMDEN
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    State                |    CT
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    Zip                  |    06514-3179
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    Country              |    US
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    Telephone            |    207-852-0024
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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