Provider Demographics
NPI:1538605217
Name:CAREW, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CAREW
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 1:15 STEPHENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6209
Mailing Address - Country:US
Mailing Address - Phone:908-601-6050
Mailing Address - Fax:
Practice Address - Street 1:15 STEPHENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6209
Practice Address - Country:US
Practice Address - Phone:908-601-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist