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General NPI Number Information
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NPI Number | 1821539420
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Entity Type | Individual
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Provider Name | DAVINIA RYAN MB BCH BAO
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Gender | Female
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 05/07/2017
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Provider Practice Location Address
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Address Line | 1275 YORK AVENUE MEMORIAL SLOAN KETTERING CANCER CENTER,
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City | NEW YORK
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State | NY
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Zip | 10065
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Country | US
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Telephone | 917-921-2931
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Fax |
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Provider Business Mailing Address
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Address Line | 425 E 76TH ST APT 6A
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City | NEW YORK
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State | NY
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Zip | 10021-2510
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Country | US
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Telephone | 917-921-2931
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 280191
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 280191
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 280191
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License Number State | NY
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