| Organization Name: | C.M. RYAN NURSE PRACTITIONER ADULT HEALTH, PLLC |
| NPI Number: | 1487922910 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAUDETTE MINTO RYAN (ANP) |
| Mailing Address: | 8 Valley Forge Dr Wheatley Heights |
| State: | NY US |
| Postal Code: | 117981215 |
| Phone Number: | 6465223502 |
| Fax Number: | |
| NPI Enumeration Date: | 12/12/2011 |
| NPI Last Update Date: | 12/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 304651 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |