Individual
RYAN BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 PELHAM PKWY S, BRONX, NY 10461-1197
(718) 696-2583
(718) 881-5074
Mailing address
240 MARLBOROUGH ST APT 8, BOSTON, MA 02116-1735
(937) 903-8492
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
302445
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2018
Last updated
03/26/2020
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