Individual
CAROL RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2157 MAIN ST, BUFFALO, NY 14214-2648
(716) 824-1070
Mailing address
65 BARLOW AVE, LACKAWANNA, NY 14218-2949
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F330881-1
NY
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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