Organization
EXTENDED MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY PATRICIA RYAN FNP (NURSE PRACTICIONER)
(585) 671-4660
Entity
Organization
Contact information
Practice address
811 RIDGE RD, SUITE 101, WEBSTER, NY 14580-2410
(585) 671-4660
(585) 671-4668
Mailing address
6824 KNICKERBOCKER RD, ONTARIO, NY 14519-9741
(315) 524-4049
(315) 524-4049
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
333050
NY
Other
Enumeration date
05/07/2007
Last updated
01/29/2008
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