Provider Demographics
NPI:1891542981
Name:HURLEY, RYAN FRANK
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:FRANK
Last Name:HURLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BROOKSIDE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2316
Mailing Address - Country:US
Mailing Address - Phone:203-219-4895
Mailing Address - Fax:
Practice Address - Street 1:664 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3537
Practice Address - Country:US
Practice Address - Phone:203-219-4895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program