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Individual
MR. RANDALL GARTH RYAN
Active
Individual
MR. RANDALL GARTH RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F340109-1
NY
363LP2300X
Primary Care Nurse Practitioner
F340109-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F340109-1
STATE LICENSE
NY
Enumeration date
03/15/2016
Last updated
03/15/2016
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