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NPI Code Detail

MEDICARE: JOAN RYAN SLP

MEDICARE: JOAN RYAN SLP
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
1235Z00000XSpeech-Language Pathologist016083NY

General Provider Information

NPI Number : 1972674182
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN RYAN SLP
Provider Business Mailing Address
First Line : 120 NEWHAM AVE
Second Line :
City : BRENTWOOD
State : NY
Zip : 11717-5624
Country : US
Telephone Number : 631-813-2143
Fax Number : 888-552-6176
Provider Business Practice Location Address
First Line : 145 DREISER LOOP
Second Line :
City : BRONX
State : NY
Zip : 10475-2704
Country : US
Telephone Number : 718-671-2955
Fax Number : 888-583-1283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2006
Last Update Date : 07/08/2007

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Directions to “ JOAN RYAN SLP” Practice Location

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