Provider Demographics
NPI:1154381085
Name:RYAN, DENNIS LAWRENCE (DPM)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LAWRENCE
Last Name:RYAN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:386 MERRIMACK ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5802
Mailing Address - Country:US
Mailing Address - Phone:978-682-0382
Mailing Address - Fax:978-975-3585
Practice Address - Street 1:386 MERRIMACK ST
Practice Address - Street 2:SUITE 1 B
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5802
Practice Address - Country:US
Practice Address - Phone:978-682-0382
Practice Address - Fax:978-975-3585
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAMA2138213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2700388OtherEVERCARE
7167111OtherAETNA
MA0316750Medicaid
2041724OtherCOVENTRY HEALTH CCN
98171903OtherNETWORK HEALTH
1002648OtherBLUE CROSS NH MEDICOMP
202669700OtherUSP DEPART OF LABOR
333420OtherHARVARD
0020407OtherNEIGHBORHOOD HEALTH
407458OtherTUFTS HMO/PPO
8167297OtherCIGNA OF NEW ENGLAND
Y71066OtherBLUE CROSS MASS
03Y002648MA02OtherBLUE CROSS ANTHEM NH
31171OtherCHILDRENS MEDICAL SECURITY
446OtherSENIOR WHOLE HEALTH
49018OtherFALLON
446OtherSENIOR WHOLE HEALTH
7167111OtherAETNA
Y75076Medicare ID - Type Unspecified