1386809952 NPI number — STEVEN INGYU RYU D.M.D.

Table of content: STEVEN INGYU RYU D.M.D. (NPI 1386809952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386809952 NPI number — STEVEN INGYU RYU D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RYU
Provider First Name:
STEVEN
Provider Middle Name:
INGYU
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RYU
Provider Other First Name:
INGYU
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1386809952
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 NEWTOWN YARDLEY RD
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
NEWTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18940-1759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-497-4977
Provider Business Mailing Address Fax Number:
215-497-4977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 NEWTOWN YARDLEY RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
NEWTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18940-1759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-497-4977
Provider Business Practice Location Address Fax Number:
215-497-4977
Provider Enumeration Date:
07/23/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223E0200X , with the licence number:  DS029499L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)