Provider Demographics
NPI:1154590248
Name:RYAN, COLLEEN ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:ANNE
Last Name:RYAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:BADER 5
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-2589
Mailing Address - Fax:617-730-0917
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:BADER 5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-2589
Practice Address - Fax:617-730-0917
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2010-02-02
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Provider Licenses
StateLicense IDTaxonomies
MA2353732084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry