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General NPI Number Information
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NPI Number | 1427143528
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Entity Type | Organization
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Legal Business Name | DR. IRENE M. RYAN
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 25 N ALBANY AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-3569
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Country | US
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Telephone | 609-345-3686
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Fax | 609-345-3698
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Provider Business Mailing Address
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Address Line | 25 N ALBANY AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-3569
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Country | US
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Telephone | 609-345-3686
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Fax | 609-345-3698
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. IRENE M RYAN
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Credential | D.C.
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Telephone | 609-345-3686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MCO 1914
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License Number State | NJ
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