Individual
RYAN TAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3850
(508) 856-1860
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP02297
RI
2085R0202X
Diagnostic Radiology Physician
Primary
365324
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110113783A
—
MA
Enumeration date
06/22/2011
Last updated
06/02/2021
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