Individual
JOHN BLAICH RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
132 NORTH ST, AUBURN, NY 13021-1829
(315) 258-8282
(315) 258-7386
Mailing address
132 NORTH ST, AUBURN, NY 13021-1829
(315) 258-8282
(315) 258-7386
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
179142
NY
208C00000X
Colon & Rectal Surgery Physician
179142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01412968
—
NY
Enumeration date
05/22/2006
Last updated
03/06/2014
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