Provider Demographics
NPI:1427346303
Name:THEN, RYNA (MD)
Entity type:Individual
Prefix:
First Name:RYNA
Middle Name:
Last Name:THEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-7000
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:5401 OLD YORK RD STE 404
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3046
Practice Address - Country:US
Practice Address - Phone:215-456-7190
Practice Address - Fax:215-456-6635
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH227102084N0400X
MT1119902084N0400X
NJ25MA092546002084N0400X, 282N00000X
FLME1564412084N0400X
390200000X
PAMD4858922084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No282N00000XHospitalsGeneral Acute Care Hospital
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program