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Individual
MARK S RYAN
Active
Individual
MARK S RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
164272
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102496BJ
PREFERRED CARE
NY
05
—
1072637
—
NY
01
—
164272-7
WORKERS COMP
NY
01
—
2593569
GHI
NY
01
—
P00003457
R.R. MEDICARE
NY
01
—
P010164272
BLUE CROSS
NY
Enumeration date
10/03/2006
Last updated
06/28/2010
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