Provider Demographics
NPI:1285458737
Name:RIPA, CODY (LAT, ATC)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:RIPA
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CRANBERRY TER
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-1143
Mailing Address - Country:US
Mailing Address - Phone:570-550-4109
Mailing Address - Fax:
Practice Address - Street 1:85 CRANBERRY TER
Practice Address - Street 2:
Practice Address - City:DURYEA
Practice Address - State:PA
Practice Address - Zip Code:18642-1143
Practice Address - Country:US
Practice Address - Phone:570-550-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0068172081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine