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Provider Information for 1689664815

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

KARA RENEE RYAN MD

Gender: FEMALE

Individual NPI: 1689664815

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1689664815
Enumeration Date 2005-10-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
CHARLESTOWN, MA 02129-9142
United States

Phone: 617-724-0287 | Fax: 617-726-2894
View Map External Link
Primary Practice Address 695 TRUMAN PKWY HYDE PARK PEDIATRICS
HYDE PARK, MA 02136-3552
United States

Phone: 617-361-1470 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other BCBS MA MA J27445
MEDICAID MA 2063531
Other TUFTS HEALTH PLAN MA 469350
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics MA 220566