Ryan, Randall Garth

Ryan, Randall Garth is an individual health care provider with primary practice located at 16 Barrington Dr , Wheatley Heights NY 11798-1302. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Ryan, Randall Garth can be contacted via phone (347) 247-4491.

Contact Information

Primary practice address
16 Barrington Dr Wheatley Heights NY 11798-1302
Phone: (347) 247-4491
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F340109-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X F340109-1 New York

Profile Details

NPI number 1124489455
LBN Legal business name Ryan, Randall Garth
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2016
Last updated Mar 15th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124489455 NPPES
New York Other F340109-1 STATE LICENSE

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