Individual
KATHLEEN L RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3412 PENNINGTON DR, WALPOLE, MA 02081-1078
(609) 744-8046
(815) 331-0775
Mailing address
3412 PENNINGTON DR, WALPOLE, MA 02081-1078
(609) 744-8046
(815) 331-0775
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA04982500
NJ
174400000X
Specialist
Primary
50223
MA
207RP1001X
Pulmonary Disease Physician
25MA04982500
NJ
207RS0012X
Sleep Medicine (Internal Medicine) Physician
25MA04982500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50223
MA LICENSE
MA
Enumeration date
12/09/2005
Last updated
12/30/2024
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