Individual
RYAN ANTHONY TIRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
479 UNION AVE, BRIDGEWATER, NJ 08807-3143
(908) 203-5200
Mailing address
33 ASHLAND AVE APT 307, WEST ORANGE, NJ 07052-5566
(908) 285-4515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00362700
NJ
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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