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General NPI Number Information
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NPI Number | 1336463058
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Entity Type | Individual
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Provider Name | MARYANN RYAN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 07/30/2016
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Provider Practice Location Address
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Address Line | 65 MAIN ST SUITE 100
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City | WARWICK
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State | NY
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Zip | 10990-1346
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Country | US
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Telephone | 845-545-5444
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Fax | 845-213-4794
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Provider Business Mailing Address
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Address Line | 65 MAIN STREET SUITE 100
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City | WARWICK
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State | NY
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Zip | 10990
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Country | US
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Telephone | 845-545-5444
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Fax | 845-213-4794
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401688
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00304400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR12128100
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 607912-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00304400
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F336446
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License Number State | NY
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