1205804085 NPI number — RUTH ALLISON RYAN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205804085 NPI number — RUTH ALLISON RYAN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RYAN

Provider First Name:

RUTH

Provider Middle Name:

ALLISON

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1205804085

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/05/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

90 CONZ ST

Provider Second Line Business Mailing Address:

#101

Provider Business Mailing Address City Name:

NORTHAMPTON

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

01060-3881

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

413-586-2230

Provider Business Mailing Address Fax Number:

413-586-3379

Provider First Line Business Practice Location Address:

90 CONZ ST

Provider Second Line Business Practice Location Address:

#101

Provider Business Practice Location Address City Name:

NORTHAMPTON

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

01060-3881

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

413-586-2230

Provider Business Practice Location Address Fax Number:

413-586-3379

Provider Enumeration Date:

03/09/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2084N0400X , with the licence number:  52145 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 2084N0600X , with the licence number: 52145 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2084P2900X , with the licence number: 52145 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 6674 . This is a "BMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 16106 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 2486136 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: J02814 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 6156801 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 521451 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 6178472 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: AA46666 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 756081 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".