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NPI Code Detail

MEDICARE: DR. RYAN GIANATASIO M.D.

MEDICARE: DR. RYAN GIANATASIO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology PhysicianP3532TX
22084V0102XVascular Neurology Physician14259SD
32084V0102XVascular Neurology Physician83282SC
42084V0102XVascular Neurology Physician260100NY
52084V0102XVascular Neurology PhysicianMD481374PA

General Provider Information

NPI Number : 1144489550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN GIANATASIO M.D.
Provider Business Mailing Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 631-813-6620
Fax Number :
Provider Business Practice Location Address
First Line : 677 CATHEDRAL DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-6018
Country : US
Telephone Number : 605-755-4150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2008
Last Update Date : 11/09/2023

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