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NPI Code Detail

MEDICARE: MEGHAN RYAN

MEDICARE: MEGHAN RYAN
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
1363LF0000XFamily Nurse Practitioner26NJ00248000NJ

General Provider Information

NPI Number : 1790010924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN RYAN
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 2440 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-6226
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2009
Last Update Date : 02/13/2014

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