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General NPI Number Information
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NPI Number | 1427938497
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Entity Type | Individual
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Provider Name | RYAN THOMAS WAPPAUS DPT
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1500 ROUTE 112 BLDG 9
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-3184
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Country | US
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Telephone | 631-849-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 5 FAIRLANE DR
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City | SELDEN
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State | NY
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Zip | 11784-1776
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Country | US
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Telephone | 631-332-1120
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State | NY
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