Provider Demographics
NPI:1487733606
Name:CUMMINGS, RYAN LAWRENCE (PT, DPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:LAWRENCE
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E GIBBSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-1907
Mailing Address - Country:US
Mailing Address - Phone:856-325-5740
Mailing Address - Fax:
Practice Address - Street 1:406 E GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-1907
Practice Address - Country:US
Practice Address - Phone:856-325-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01287400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120715SAVMedicare PIN