Provider Demographics
NPI:1568140630
Name:CAREY, RYAN PETER (OD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PETER
Last Name:CAREY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 CHESTNUT ST.
Mailing Address - Street 2:SUITE 417
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4304
Mailing Address - Country:US
Mailing Address - Phone:215-627-4448
Mailing Address - Fax:215-627-5798
Practice Address - Street 1:1015 CHESTNUT ST.
Practice Address - Street 2:SUITE 417
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19107-4304
Practice Address - Country:US
Practice Address - Phone:215-627-4448
Practice Address - Fax:215-627-5798
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG004043152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist