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General NPI Number Information
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NPI Number | 1770442899
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Entity Type | Individual
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Provider Name | RYAN MARK REBECA MSN, RN, CNEN, CRRN
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Gender | Male
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 2014 WASHINGTON ST
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City | NEWTON
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State | MA
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Zip | 02462-1699
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Country | US
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Telephone | 617-243-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 55 PLYMOUTH ST UNIT 39
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City | WHITMAN
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State | MA
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Zip | 02382-1673
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Country | US
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Telephone | 860-609-7447
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN2332618
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License Number State | MA
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