Individual
EMILY A. RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-4088
Mailing address
24 MOHAWK DR, WEST HARTFORD, CT 06117-2227
(734) 262-3785
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101015327
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010H262530
BLUE CROSS-BLUE CROSS
—
05
—
494899711
—
MI
01
—
ER015327
CHAMPUS-CHAMPUS
—
Enumeration date
07/12/2006
Last updated
11/05/2021
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