Ryan Canedo

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

755628 Issued in NY

Practice address

79 Middleville Rd
Northport, NY 11768-2200

Phone

(631) 261-4400

NPI assigned

Dec 22, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1942665724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682296",
            "telephone_number": "631-261-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "998 Crooked Hill Rd",
            "address_2": "Bldg 47",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "NY",
            "postal_code": "117171019",
            "country_code": "US",
            "telephone_number": "631-761-2068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANEDO",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "NYCPS-P-225",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "755628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanja Cale Still, PHD
• Ingrid Sharon Campbell, L-CSW
• Patrick C Campbell, R.T.
• Valerie Marie Campos, RN
• John Everett Cancroft, D.D.S.
• Carl F Cannata, RPA-C
• Justine Marie Cannavo
• Denise Riegel Capaccio, MS CCC SLP
• Nicholas R. Capece, M.D.
• Milagros Enriquez Capiral, PHARMACIST

• Psychiatric/Mental Health Registered Nurse in Northport, NY
• Providers in Northport, NY by specialty
• Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.