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General NPI Number Information
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NPI Number | 1467553131
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Entity Type | Individual
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Provider Name | EILEEN A RYAN PT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 CEDAR GROVE LN SUITE C
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City | SOMERSET
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State | NJ
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Zip | 08873-4700
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Country | US
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Telephone | 732-356-5363
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Fax | 732-356-5364
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Provider Business Mailing Address
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Address Line | 15 CORNELIUS WAY
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City | SOMERSET
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State | NJ
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Zip | 08873-7349
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Country | US
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Telephone | 732-873-0670
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Fax | 732-356-5364
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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 | 40QA00509400
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License Number State | NJ
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