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General NPI Number Information
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NPI Number | 1528447182
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Entity Type | Individual
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Provider Name | RYAN PATRICK HENEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1823 VERMONT ROUTE 107
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City | BETHEL
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State | VT
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Zip | 05032-9324
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Country | US
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Telephone | 401-234-9913
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Fax | 802-234-5507
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Provider Business Mailing Address
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Address Line | 1823 VERMONT ROUTE 107
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City | BETHEL
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State | VT
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Zip | 05032-9324
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Country | US
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Telephone | 401-234-9913
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Fax | 802-234-5507
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LP03467
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License Number State | RI
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