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Individual
MICHAEL DONALD RYAN
Active
Individual
MICHAEL DONALD RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009493
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026590701
UNIVERA
NY
01
—
000570451001
BLUE CROSS/BLUE SHIELD
NY
05
—
02511291
—
NY
01
—
9511860
INDEPENDENT HEALTH
NY
Enumeration date
05/24/2006
Last updated
02/09/2021
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