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Individual

DR. JASON W RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
263 FARMINGTON AVE, MAIN BUILDING, 2ND FLOOR, FARMINGTON, CT 06030-2202
(860) 679-3343
(860) 379-4256
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
216735
MA

Other

Enumeration date
08/31/2006
Last updated
09/29/2022
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