Jill Ryan

Individual provider Active NPI Licensed Practical Nurse · Cleveland, NY

NPI 1114212487 · NPPES record last updated Jun 15, 2011

Key facts

NPI
1114212487
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
293489 (NY)
Practice address
260 State Route 49
Cleveland, NY 13042-2206
Phone
(315) 476-0600
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
293489NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 293489 NY Yes

Addresses

Primary practice location

260 State Route 49
Cleveland, NY 13042-2206

Mailing address

260 State Route 49
Cleveland, NY 13042-2206

Other providers in Cleveland, NY

All providers in Cleveland, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.