Ryan, Edward Thomas
Ryan, Edward Thomas is an individual health care provider with primary practice located at 55 Fruit St Grj 5 Infectious Disease Associates, Boston MA 02114-2696. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Ryan, Edward Thomas can be contacted via phone (617) 726-6175.Contact Information
Primary practice address
55 Fruit St Grj 5 Infectious Disease Associates
Boston MA 02114-2696
Phone: (617) 726-6175
Fax: (617) 726-7416
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 72191 | Massachusetts |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 72191 | Massachusetts |
Profile Details
| NPI number | 1255321022 |
|---|---|
| LBN Legal business name | Ryan, Edward Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Oct 23rd, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255321022 | NPPES |
| Massachusetts | MEDICAID | 3168735 | |
| Massachusetts | Other | 072191 | |
| Massachusetts | Other | J09931 |
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