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General NPI Number Information
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NPI Number | 1669852950
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Entity Type | Individual
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Provider Name | RYAN ROQUE ANTHONY ALABAN
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Gender | Male
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 4922 LASALLE RD NMS HEALTHCARE
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City | HYATTSVILLE
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State | MD
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Zip | 20782-3302
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Country | US
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Telephone | 301-864-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 8811 COLESVILLE RD APT 824
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City | SILVER SPRING
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State | MD
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Zip | 20910-4335
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Country | US
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Telephone | 443-775-1822
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 07504
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License Number State | MD
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