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General NPI Number Information
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NPI Number | 1801078456
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Entity Type | Organization
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Legal Business Name | PATRICE RYAN
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 924 MAIN ST
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City | HELLERTOWN
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State | PA
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Zip | 18055-1525
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Country | US
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Telephone | 610-838-7945
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Fax | 610-838-1464
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Provider Business Mailing Address
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Address Line | 924 MAIN ST
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City | HELLERTOWN
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State | PA
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Zip | 18055-1525
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Country | US
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Telephone | 610-838-7945
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Fax | 610-838-1464
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICE A RYAN
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Credential | DPM
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Telephone | 610-838-7942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC003030L
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License Number State | PA
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