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General NPI Number Information
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NPI Number | 1447252796
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Entity Type | Individual
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Provider Name | STEPHEN DENNIS RYAN MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 1415 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3038
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Country | US
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Telephone | 585-922-2800
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Fax | 585-922-2864
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Provider Business Mailing Address
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Address Line | 100 KINGS HWY S
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City | ROCHESTER
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State | NY
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Zip | 14617-5504
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Country | US
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Telephone | 585-922-0553
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 206383
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 206383
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License Number State | NY
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