Individual
CASEY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 ADAMS AVE STE B13, HAUPPAUGE, NY 11788-3618
(631) 617-6011
Mailing address
140 ADAMS AVE STE B13, HAUPPAUGE, NY 11788-3618
(631) 617-6011
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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