MEDICARE: RYAN BRINK

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	363A00000X	Physician Assistant	MA066448	PA

General Provider Information

NPI Number	:	1467269258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN BRINK

Provider Business Mailing Address
First Line	:	4218 GENEVA ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1127
Country	:	US
Telephone Number	:	814-673-7428
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 FORBES AVE FL 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3203
Country	:	US
Telephone Number	:	814-673-7428
Fax Number	:

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

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	03/27/2025

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Directions to “ RYAN BRINK ” Practice Location

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