Individual
RYAN ELIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22-18 BROADWAY, FAIR LAWN, NJ 07410-3016
(862) 591-5341
Mailing address
1823 MANOR DR APT D, UNION, NJ 07083-4654
(862) 591-5341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NJ
Other
Enumeration date
08/02/2022
Last updated
09/12/2022
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