Provider Demographics
NPI:1407747660
Name:MUCCIO, RYAN JOHN
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JOHN
Last Name:MUCCIO
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 1:4441 CASA IDA CT
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89061-0126
Mailing Address - Country:US
Mailing Address - Phone:702-672-6559
Mailing Address - Fax:
Practice Address - Street 1:4441 CASA IDA CT
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89061-0126
Practice Address - Country:US
Practice Address - Phone:702-672-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)