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General NPI Number Information
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NPI Number | 1336026301
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Entity Type | Individual
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Provider Name | RYAN J TIERNEY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 30 BROAD ST BSMT A
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City | NEW YORK
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State | NY
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Zip | 10004-2387
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Country | US
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Telephone | 646-790-7454
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Fax |
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Provider Business Mailing Address
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Address Line | 102 MADISON AVE FL 8
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City | NEW YORK
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State | NY
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Zip | 10016-7584
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Country | US
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Telephone | 212-759-2282
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Fax | 212-379-2123
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 054571
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License Number State | NY
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