Individual
RYAN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
57 AMHERST LN, HICKSVILLE, NY 11801-3303
(347) 383-0769
Mailing address
57 AMHERST LN, HICKSVILLE, NY 11801-3303
(347) 383-0769
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
788590
NY
251J00000X
Nursing Care Agency
Primary
788590
NY
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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