| Doctor Name: | JESSICA E RYAN |
| NPI Number: | 1013161967 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 002191 |
| Business Practice Address: | 41 Brewster Rd Bristol, CT - 060105161 |
| Business Phone Number: | 8602714364 |
| Business Fax Number: | 8604445144 |
| Mailing Address: | 41 Brewster Rd, BRISTOL |
| State: | CT |
| Postal Code: | 06010 |
| Phone Number: | 8602714364 |
| Fax Number: | 8604445144 |
| NPI Enumeration Date: | 11/05/2008 |
| NPI Last Update Date: | 11/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 002191 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |