Doctor Name: | MR. JOSEPH FRANCIS RYAN |
NPI Number: | 1124119409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | A.S. |
License Number: | |
Business Practice Address: | 555 Willard Ave 116a Newington, CT - 061112631 |
Business Phone Number: | 8605946320 |
Business Fax Number: | 8606678642 |
Mailing Address: | 85 Pepper Bush Ln, NEWINGTON |
State: | CT |
Postal Code: | 061114242 |
Phone Number: | 8606671901 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |