Provider Demographics
NPI:1962988618
Name:VASS, RYAN (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:VASS
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 TWYCKENHAM RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1636
Mailing Address - Country:US
Mailing Address - Phone:352-537-8277
Mailing Address - Fax:
Practice Address - Street 1:904 TWYCKENHAM RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1636
Practice Address - Country:US
Practice Address - Phone:352-537-8277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare