MEDICARE: CLAUDETTE MINTO RYAN NP

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
1	363LA2200X	Adult Health Nurse Practitioner	APRN-NP313605	GA
2	363LA2200X	Adult Health Nurse Practitioner	F304651	NY

General Provider Information

NPI Number	:	1437330503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDETTE MINTO RYAN NP

Provider Business Mailing Address
First Line	:	8 VALLEY FORGE DR
Second Line	:
City	:	WHEATLEY HEIGHTS
State	:	NY
Zip	:	11798-1215
Country	:	US
Telephone Number	:	646-522-3502
Fax Number	:	631-920-0976

Provider Business Practice Location Address
First Line	:	8 VALLEY FORGE DR
Second Line	:
City	:	WHEATLEY HEIGHTS
State	:	NY
Zip	:	11798-1215
Country	:	US
Telephone Number	:	646-522-3502
Fax Number	:	631-920-0976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	05/21/2026

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