Active NPI
Julia Jean Ryan
- Developmental Therapist
- Marlborough, MA
National Provider Identifier
1972344919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- S13164376
- Practice address
- 340 Maple St Ste 203
Marlborough, MA 01752-3200 - Phone
- (508) 624-0304
- Fax
- (508) 624-0391
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | S13164376 | MA | Primary |
Addresses
Primary practice location
340 Maple St Ste 203
Marlborough, MA 01752-3200
Mailing address
241 Old Sudbury Rd
Sudbury, MA 01776-1842
Phone (978) 460-4310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S13164376 | MA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1972344919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241 OLD SUDBURY RD",
"city": "SUDBURY",
"state": "MA",
"postal_code": "017761842",
"telephone_number": "978-460-4310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MAPLE ST STE 203",
"city": "MARLBOROUGH",
"state": "MA",
"postal_code": "017523200",
"telephone_number": "508-624-0304",
"fax_number": "508-624-0391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "JULIA",
"middle_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "MA",
"license": "S13164376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.