Individual
DR. CHARLES JOSEPH RYAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3077 E LAKE RD, SKANEATELES, NY 13152-9024
(315) 685-3966
(315) 685-5833
Mailing address
3077 E LAKE RD, SKANEATELES, NY 13152-9024
(315) 685-3966
(315) 685-5833
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
176888-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176888-1
NEW YORK STATE LICENSE
NY
Enumeration date
03/02/2013
Last updated
03/02/2013
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