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NPI Code Detail

MEDICARE: RYAN LAWS BETHUNE

MEDICARE: RYAN LAWS BETHUNE
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1760201305
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN LAWS BETHUNE
Provider Business Mailing Address
First Line : 3174 RIVERDALE AVE OFC 1
Second Line :
City : BRONX
State : NY
Zip : 10463-3839
Country : US
Telephone Number : 718-530-8496
Fax Number :
Provider Business Practice Location Address
First Line : 3174 RIVERDALE AVE OFC 1
Second Line :
City : BRONX
State : NY
Zip : 10463-3839
Country : US
Telephone Number : 718-530-8496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2024
Last Update Date : 10/09/2024

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Directions to “ RYAN LAWS BETHUNE ” Practice Location

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