| Doctor Name: | DR. TERRY DANIEL RYAN |
| NPI Number: | 1831538784 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 027773 |
| Business Practice Address: | 11 West Ln Niantic, CT - 063573715 |
| Business Phone Number: | 8607390073 |
| Business Fax Number: | 8607390073 |
| Mailing Address: | 11 West Ln, NIANTIC |
| State: | CT |
| Postal Code: | 063573715 |
| Phone Number: | 8607390073 |
| Fax Number: | 8607390073 |
| NPI Enumeration Date: | 06/24/2013 |
| NPI Last Update Date: | 06/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS0132X |
| License Number: | 027773 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ophthalmologic Surgery |
| Taxonomy Definition: | |